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a�3aso-oo2o City ofi Zephyrhills Permit Application -- -FaX-s�saao-oo2� <br /> .__._. <br /> � Building Department �.�-'" - , <br /> %� <br /> Date Received Phone Contact for Permitt�n ( �J� -- 1(� 7� <br /> Owner's Name � 1 (x, � l�C: �YI�'' � O�vner Phone Number <br /> Owner's Address 2J M O�d�c?C? L C�� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � �� Z �i<G���G'��C�L�C- LOT# � <br /> SUBDIVISION � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM � OTHER r <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK �G'`� � `��{} �i I�YGII N �yt�� ���( �i S� <br /> BUILDING SIZE �-�,.$�_FOOTAGE� HEIGHT � <br /> �UILDING : $ / DOb��j�, ,<'VALUATION OF TOTAL CONSTRUCTION <br /> �� r <br /> .,.,. <br /> QELECTRICAL � $'-- - -~-- " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �'L�� ' <br /> QPLUMBING $ �(-� <br /> 3a � ��;5s�r� �. <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ' ��µ-�� �,tL�� <br /> .� 1 �' f <br /> OGAS Q ROOF�NG Q SPECIALTY � OTHER � ��� � �C��� <br /> � ��� �����w. <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO 1���; �a���,.�+ <br /> ��� <br /> BUILDER �`' u ��r�� � COMPANY '�''��'''t'�� -J t��- <br /> SIGNATURE �f - ������ REcisreReD Y/ N FEE CURRE� Y J N <br /> Address License# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# � <br /> MECHANICAL COMPANY �- <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address s 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,Constructfon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes&1 dumpster;Site Work Permit for subdivisionsAarge 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 consVucUon. <br /> Directions: <br /> Fill out apptication completely. <br /> Owner&ConUactor 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 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 shingles Sewers Service Upgrades AIC Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />