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City of Zephyrhills Permit App <br /> lication Fax-813-78C1-0021 <br /> 813-780-0020 Building Department <br /> � d3 � 7? <br /> ate Received � Phone Contact for Permfttin � <br /> ��r� ��L Owner Phone Number <br /> ��3 -3q� °' <br />�wner's Name �/� �(j 7_ O 9�,�, <br /> /G �-� jb �1. S� �y��, �� pwner Phone Number <br /> hvner's Address �� <br /> S��� _ Owner Phone Number <br />=ee Simple Titleholder Name <br /> Fee Simpie Titleholder Address s '�,`Y � ;a <br /> LOT# <br /> ,s-�,e-r✓�� <br /> JOB ADDRESS <br /> ��S O� PARCEL ID# �pgTAINED FROM PROPERTY TAX NOTICE) <br /> SUBDIVISION � <br /> e NEW CoN57R e ADD/ALT <br /> � SIGN Q DEMOLISH <br /> WORK PROPOSED INSTALL REPAIR <br /> SFR � COMM � OTHER � <br /> PROPOSED USE � gLOCK Q FRAME � STEEL Q <br /> TYPE OF CONSTRUCTION Q � �/V ����� <br /> .�NS f/�-�tc. /s"5 ' of � �fi-�' �'Y �Y <br /> DESCRIPTION OF WORK � G ; <br /> BUILDING SIZE <br /> SQ FOOTAGE ��s HEIGHT <br /> �j tu <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION� � .2�p. <br /> OELECTRICAL $ AMP SERVICE � <br /> PROGRESS ENERGY �] WR.E.C. <br /> �PLUMBING $ / <br /> VALUATION OF MECHANICAL INSTALLATION � ' � / <br /> �MECHANICAL $ <br /> GAS Q ROOFING Q SPECIALTY � OTHER YES �� �2� <br /> � FLOOD ZONE AREA 0 � <br /> FINISHED FLOOR ELEVATIONS <br /> CiDMPANY Y� N FEE CURRE� Y/N <br /> BUILDER REGISTERED <br /> SIGNATURE License# <br /> Address <br /> ------ <br /> COMPANY Y! N FEE CURRE� Y 1 N <br /> ELECTRICIAN REGISTERED <br /> SIGNATURE License# <br /> Address <br /> COMPANY FEE CURRE� Y 1 N <br /> PLUMBER REGISTERED Y/ N <br /> SIGNATURE <br /> License# �_ <br /> Address �_ <br /> COMPANY FEE CURRE� Y 1 N <br /> MECHANICAL REGISTERED Y I N <br /> SIGNATURE License# � <br /> Address � (�� !",���� <br /> /� COMPANY �� � � <br /> OTHER � REGISTERED N FEE CURRE� Y I N <br /> 31GNATURE C� C a/(�I7 l/ <br /> � � ���, 5�. ������ �3�6 �icense# � <br /> Address �G� ` <br /> RESIDENTIAL Attach(2)Plot Plans;(2) <br /> sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new co�struction, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Constructlon Plans,Stormwater Plans wl Silt Fence installe , <br /> 1 set of Energy Forms.R-O-W Pe�it for new consWction. <br /> Sanitary FaciliUes 8 1 dumpster;Site Work Permit for subdivisionsllarge projec s <br /> COMMERCIAL Attach(3)comP�ete sets of Building Plans plus a Life Safety Page;( ) <br /> Permit for all new projects.All commercial requirements must meet compliance <br /> Minimum ten(10)working days after sub�ttai date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence insta e , <br /> Sanitary Facilities 8 1 dumpster.Site Wo <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. �i�tion,notarized <br /> Owner 8 Contractor sign back of app' rades over 57500) <br /> If over E2500,a Notice of Commencement is requfred. (AIC upg <br /> Agent(for the contractor)or Power of Attomey(for the ovmer)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 UP9rades A/C Fences(PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />