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a�a-78o-oozo City of Zephyrhills Permit Application Fax-813-780-OU21 <br /> � Building Department � <br /> � <br /> Date Received Phone Contact for Permittin l �?? — �� <br /> � Q Zw �,�� <br /> Owner's Name LC�YI�2tJ � �B+1�p i/�'Yl! Owner Phone Number ld�3'— �� � <br /> Owner's Address �� y7 `c� `S�` Owner Phone Number �`3"' ��Z' lU�� <br /> Fee Simple Titleholder Name . ���� � Owner Phone Number <br /> Fee Simple Titleholder Address �+�� <br /> JOB ADDRESS � ��'"� LOT# C� <br /> SUBDIVISION . PARCEL ID# 02' �°�—u (X/�� ���'?GU —GU�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISN <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �NS[r�v �3J'�(n'� [�f� P��/ ��'���'� °��G� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION �Gl� � <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> �. f���� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION JL� ` ° <br /> � ° � <br /> QGAS Q ROOFING Q SPECIALTY � OTHER ��lrJ��LF/ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO 2 y'� <br /> . ,J (/ <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N <br /> Address ' License# <br /> ELECTRICIAN COMPANY <br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# <br /> PLUMBER COMPANY <br /> SIGNATURE rte�ISreReo Y/ N FEE CURRE� Y/N ' � <br /> Address License# <br /> MECNANICAL , COMPANY <br />_.__SIGNATURE____ _Re�is�Reo _ _. YJ_-N__ _ F�cueeen __Y_/_N _____ _ __ __ _ __ _ <br /> Address Llcense# <br /> OTHER . COMPANY �s� ���� (.QJ� <br /> SIGNATURE ' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �� .�� �U��f'/t' 7'�vi2,�/}� �C ���G License# (��eA�(�`7 Z <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon,. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon 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 wnstruction. <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 /> Dlrections:" � • <br /> Fill out application completely. <br /> Owner&Confractor sign back of applfcaUon,.notarized � <br /> If over$2500,a Notice of Commencement(s 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 /> OVER THE`COUNTER PERMITTING (Front of Appllcatlon 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 />