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813-78Q-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received i Z `� tii - <br /> -� 2- - � -� Phone Contact for Permit ��? t L7 __ �y <br /> , �a <br /> Owne�'s Name -' �:��- U'�\ � �}`:,��� - ----- Owner Phone Number t'J i � _. �i, s' --1�.�_i <br /> Owner's Addres's � C(O Ci: 1,�.^ , ,�}/�-S S r^ �� =;� '� � � <br /> l't���� Owner Phone Number <br /> Fee Simple Titleholder Name -� Owner Phone Number <br /> Fee Simple Titleholder Address <br /> � ��JOB ADDRESS ` ��� ��. ��� U �- G-t=�f�I,�� L�l����� �" � LOT# <br /> SUBDIVISION PARCEL ID# 1 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONS7R 8 ADDlALT [� SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIP __ ��/�-`"-�-A-��A-�' �Ci.ti. � �l'.�bE �.�1-YL-�`�:�C <br /> BUILDING SIZE �� X �J � gQ FOOTAGE ��-x�� HEIGHT I( � � � I <br /> �U�ILDING �y � (�`. VALUATION OF TOTAL CQNSTRUCTION <br /> Y— N . <br /> _..�-._� . --__ , <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �.� <br /> MECHANICAL � ( �`� <br /> 0 $ VALUATION OF MECHANICAL INSTALLATION ��,} <br /> J'� <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> � ` ( <br /> BUILDER �� �(`.� ;-, �' COMPANY � C.��'?�+ 1 :.i7�' �� �`c:;.�L: ,1-;-:: LI. � <br /> SIGNATURE � i � -E.�rZ- � REGISTERED Y/ N FEE CURRE� Y/N <br /> f _ <br /> Address �•S (� (_ c{,A-1-`r t��� L.��.c' �f��,?, `^1 J'�1? License# C��' CQ5 J� > ! �-> <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address license# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address License# � -� <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 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 /> Sanftary Facilities 8 1 dumpster;Site Work Permit for subdivisions/large 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 construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ,•"'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> '" Agent(for the contractor)or Powerof Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppHcat(on Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlobSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />