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813-780-0020 City of Zephyrhills Permit A lication <br /> PP Fax-813-780-0021 <br /> Building Department <br /> Date Rec�ived <br /> Phone Contact for Permittfn �5 �- L�z c,/ __ L�/��� <br /> Owner's Name �� �,�, \ �,�� �-��3 j <br /> Owner Phone Number �� �– ��Z - L�(�� <br /> Owner's Address �p�5 l ,j^� �' � l � 3� <br /> Owner Phone Number <br /> Fee Simple Titleholder Name { , � ��� a 730 � <br /> Owner Phone Number <br /> Fee Simple Titleholder Address �p t7 S� � j�,L �� `_ r !', <br /> Y1 1 33��I� <br /> JOB ADDRESS ��� �/ �� �� � � ` ',`� �, 33�� <br /> LOT# �] <br /> SUBDIVISION <br /> PARCEL ID# <br /> WORK PROPOSED B (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NEW CONSTR ADD/ALT � SIGN O Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [� SFR Q COMM ^ <br /> TYPE OF CONSTRUCTION � BLOCK �---1 OTHER <br /> Q FRAME � STEEL � <br /> DESCRIPTION OF WORK � , �j ; � � •� <br /> BUILDfNG SIZE �X Zd� SQ FOOTAGE�� <br /> HEIGHT <br /> QBUILDING g <br /> ,3 �j(�(��� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ <br /> AMP SERVICE � PROGRESS ENERGY Q <br /> W.R.E.C. <br /> QPLUMBING $ f(���� I a�S � ��.�,t� <br /> QMECHANICAL $ � ( l � � � <br /> VALUATION OF MECHANICAL INSTALLATION � �GLP'� 1'E'^ <br /> ` �,�� � <br /> �/(''� <br /> �GAS � ROOFING � SPECIALTY � OTHER �� � ����'``�~�� <br /> FINISHEDFLOORELEVATIONS FLOODZONEAREA �YES 1�� ���2°t �3,-�,(; � <br /> J�� <br /> BUILDER �� � <br /> SIGNATURE Z Q �1 r���` � K� �73� COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ��j� �t/i`/� �� � ��QQk � , `� 3�� <br /> License# <br /> ELECTRICIAN <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# �_ <br /> aLUMBER <br /> 51GNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# �— <br /> AECHANICAL <br /> tIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br />�THER <br /> IGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# �— <br /> ESIDENTIAL 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,Construction Pians,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities&1 dumpster;Site Work Permit for subdivisions/large projects <br />�MMERCIAL Attach(3)complete sets of Buiiding 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 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> GN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'PROPERTY SURVEY required for all NEW construction. <br /> rections: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of appHcation,notarized <br /> If over E2500,a Notice of Commencement is required. (A/C upgrades over:7500) <br /> Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> ER THE COUNTER PERMITTING (Front of Appiication Only) <br />�oofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />