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813-780-0020 City of Zephyrhills Permit Application FaX-e�a-�eo-oo2� <br /> Buiiding Department <br /> Date Received <br /> P one Contact for ermitt �,1� �`� _ `��� <br /> ? '�. � e t ' . .. _ .., ._ .___. ---__ � . _ , <br /> Owner's Name ti')�� ! "" �_' �. � r ;` r'. l � • <br /> � � ' Owner Phone Number <br /> ;,--� ,� �. .— "Ic" — 1�� �� <br /> Owner's Address �. �,i�".��� �-� ,��'-�'t` - � ,ry <br /> Owner Phone Number \ --�1�- ""�-��� <br /> Fee Simple Titleholder Name <br /> Owner Phone Number <br /> Fee Simple Tttieholde�Address <br /> JOB ADDRES3 � � ��� �� <br /> �t C PE'� <br /> LOT# <br /> SUBDIVISION PARCEL ID# '1 ,N��F—�l'(.,i�� . <br /> l7•• t..l� l�j--��l <br /> WORK PROPOSED B (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NEW CONS7R 8 ADD/ALT [�� SIGN � O DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [� SFR Q COMM <br /> TYPE OF CONSTRUCTION Q BLOCK � OTHER <br /> Q FRAME [� STEEL � <br /> DESCRIPTION OF WORK ��������- � � �l <br /> BUILDING SIZE SQ FOOTAGE �'1�. <br /> HEIGHT <br /> ° BUILDING � - <br /> � $ 1����.?- VALUATION F TOTAL CS?NS]'&lJG�1p�._-� <br /> `._,y._�._.___.... _ __...__ � : <br /> ----�- ----- <br /> - <br /> ELECTRICAL $ AMP SERVICE � <br /> PROGRESS ENERGY [� W.R.E.C. <br /> OPLUMBING g <br /> QMECHANICAL $ �'� �� � �� <br /> VALUATION OF MECHANICAL INSTALLATION <br /> [�GAS Q ROOFING Q SPECIALTY [—� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA <br /> QYES NO <br /> BUILDER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# � <br /> ELECTRICIAN <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# � <br /> PLUMBER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> Ucense# <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> } � <br /> SIG ATURE � ( � l. Cf�- ' � COMPANY �' ��1� <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �'74 k� <br /> ,� ���' License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new constructfon. <br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Sfte Work Permit for all new projects.All commercfal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "'"PROPERTY SURVEY required for all NEW construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of appNcaUon,notarized <br /> If over=2500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />