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a�a-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> s e <br /> Building Department <br /> Date Received - - <br /> Phone Contact forPermitting �l�a 3��1 -- ���� <br /> Oduner's Name �Q O�j' � (��2 Owner Phone Mumber 3 5 �'" ���— �0 � <br /> Obrner's dlddress �,C� . a�I1 (o � C�-�� J�}� p�er Phone Number <br /> Fee.Simple Titleholder Name Owner Phone Number <br /> Fee Simple-Titleholder Address <br /> JOB ADDRESS �� O a-3 `I� A V.A. 2.0 P� Q�i\l j LOT# � <br /> SUBDIVISION � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> MIORK PetOPOSED e NEW CONSTR ADD/ALT 0 SIGN Q - Q DEMOLISH � <br /> INSTALL � REPAIR <br /> PROPOSED USE , Q SFR Q COMM 0 OTHER p p <br /> TVPE OF CONSTRUCTIOM Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK ��e�o�c_ ' (�„�Q1.t_. �D7'� <br /> BUILDING SIZE `� �� d� SQ FOOTAGE� HEIGHT <br /> QBUILDING $ G� �.� S � VALUATION OF TOTAL CONSTRUCTION �-� ��—I � . ('�l7 <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q . W.R.E.C. <br /> QPLUMBING $ <br /> . . . 52.3� <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION -f-��� <br /> t/ <br /> QGAS �Z] ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER , COiNPANY �i�h� Q V����• LL� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y N <br /> Address ����- ' r�. SW'.��e l� �+`�`� , <br /> �icense# CCC, 13�. ��.� <br /> ELECTRICIAId COMPANY <br /> SIGIdATUE2E 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# r— <br /> MECHANICAL COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> IAddress , License# <br /> . <br /> OTHER - COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � License# � <br /> FtESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Flans;(1)set,of.Energy Forms;R-O-W PeRnit for new construction, <br /> Minimum ten(10)working days after submittal date. Requi�ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllitles 8�1 dumpster;Site Work Permit for subdivlsions/large projects <br /> COAAMERCIAL Attach(3)complete sets of Build(ng Plans plus a Life Safery Page;(1)sef of Energy Forms.R-O-W Permit for new construction. i <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 consVuction. <br /> Directions: - <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized. <br /> If over b2500,a Notice of Commencement Is requlred. (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 /> O!!ER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW . <br />