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a�s-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received „� '�' <br /> Phone Contact for Permittin _ <br /> Owner's Name '�}h�5� (Y�c���W Owner Phone Number y(p Q'— f a�G <br /> Owner's Address ��g �/U'Q�{y-' y-2 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number —� <br /> Fee Simple Titleholder Address <br /> JOBADDRESS S`�3l 5�j'�-, LOT# C� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT �� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL � �--� <br /> DESCRIPTION OF WORK C �Y�IP�J {? � "''" <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> �BUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY <br /> Q W.R.E.C. <br /> QPLUMBING $ <br /> �MECHANICAL $ a��• VALUATION OF MECHANICAL�NSTALLATION <br /> OGAS 0 ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— <br /> MECHANICAL — COMPANY l�T��-Y'1 S IrV�L�S � f 1" (�SL b <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address 1�-Q•�X ) � Z �{11��S ��- '� ���'cj License# CAC ��� '�9� <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;(7)set of Energy Forms;R-O-W Permit 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 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 Permit 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 /> ��-n�ir�rnie�����ir„� <br /> u�recnons 'y''-L11J-"" <br /> Fill out application completely. <br /> Ovmer&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 Power of Attorney(for the owner)would be someone with notarized letter from ovmer autFiorizing same <br /> DVER THE COUNTER PERMITTING (Front of Application Only) <br /> 2eroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />