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a�3-�eo-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 �/�. Owner Phone Number <br /> Owner's Address 3�-! b LCi �' �r �'t � ��`ti r'l._ p�er Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOBADDRESS �� ��OVtr �Dr Zt I� /(n��� 1—L � � LOT# �� <br /> SUBDIVISION ���v`��rtf[��1• Pjl� PARCEL ID# 3�'�J 'd� "�S�1 �'b��� �s'b d <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADDlALT � SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �rOd� H"� �c n`�Ot/���-�t S I'��nf(,LS <br /> BUILDING SIZE � SQ FOOTAGE �� HEIGHT � <br /> QBUILDING S VALUATION OF TOTAL CONSTRUCTION � � O O •�� <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � r �1 `� <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER L1/G(/� <br /> -1 l 7" <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 <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY Scott Biackman Roofing, �f1C. <br /> SIGNATURE REGISTERED Y/ N , � Y/N <br /> Address $BnLi�cense ���—C.GCC)s�t r <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,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FacfBties 8 1 dumpster;Site Work Pertnit 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 constructfon. <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 /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of appiication,notarized <br /> If over 52500,a Notice of Commencement is requlred. (A/C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(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 shingies Sewe?s Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />