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sia-�ao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Deparlment <br /> Date Received — � �( <br /> �—�-�T� Phone Contact for Permitting <br /> Owner's Name ��'J � I.� �s <br /> Owner Phone Number ��' (?� <br /> Owner's Address ��� ��IN1�V� �}IL pwner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �3 ��'r'� � Q �� "'� <br /> LOT# <br /> SUBDIVISION YH I Q �`i P PARCE�ID# � ���/^Z/�����'�d�OO� � �j d <br /> � (OBTAINED FROM PROPERTV TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDlALT SIGN � � DEMOLISH <br /> INSTALL e REPAIR <br /> PROPOSED USE � SFR � COMM � OTHE C <br /> TYPE OF CONSTRUCTION � BLOCK � FR,4ME � STEEL � y�� Oa ri+'� <br /> DESCRIPTION OF WORK �Q Cy yCl� �j P �� ,�� �� M�jM �-��� <br /> ..� <br /> BUILDING SIZE !'�( � SQ FOOTAGE �V� � Sy���~ <br /> HEIGHT ---��� <br /> �BUILDING $ ? <br /> Tj Q�,Q{J VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> �PLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION . ���(� <br /> � <br /> �GAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER � / �Q�.j�e2 ��N <br /> SIGNATURE �OMPANY �.� � <br /> REGISTERED Y N FEE CURRE� J�.J <br /> Address ° � O ga y <br /> �T E- a o�- /�'1�ON`�} � �icense# C C s <br /> ELECTRICIAN COM PANY <br /> SIGNATURE REGISTERE� Y! N FEE CURRE� Y/N <br /> Address <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y! N FEECURRE� Y!N <br /> Address <br /> License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address <br /> License# <br /> 1 1 I 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new conshuction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wf Silt Fence installed, <br /> Sanitary Facilities&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 perm it 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 E2500,a Notice of Commencement is required. (qIC upgrades over 57500) <br /> " Agent(for the coniractor)or Power of Attorney(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(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />