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813-760-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Departrnent <br /> Dat�Rec�ivzd _�� -� Phone Contact for Permitting .3� ��9 - Q�°�� <br /> Ou�ner's fdame � �O��4 I� Owner Phone Mumber ��3"�o ss- �Y�O�' <br /> r vi� . <br /> Odvner's Address �3 J�.3�J 7 �1 �fL��E O Owner�'hone Number <br /> Fee Simple Titleholder Mame Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 5c3 7 7 �?��� 3�V� . LOT# � <br /> SUBDIVISION PARCEL ID# I I�Z G ' Z�-dO 1 O " 1 Z LOO - O O 9 O <br /> (OBTAINEO FROM PROPERTY TAX NOTICE) <br /> VYORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q � DEMOLISH <br /> B INSTALL e REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTIOtd BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK � L�C M O <br /> BUILDIfVG SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP.SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ ���� <br /> . � �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER ' <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER nn c , COAAPANY �7 C-� f�/y/eKi .�J 1��2�c"b ��� <br /> SIGNATURE ���"l�✓�� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ��v2 y U.s � � Sou Tr'1 License# C�C I$19 (r-1 S� <br /> ELECT6tICIAM COMPANY <br /> SIGfdATURE REGISTERED Y/ N FEE CURRED Y/N <br /> Address � License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECH6INICAL � COMPANY J-�-x- � I�V7�'" �/ —��yS <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ��� � -��� S�-`� 3 � License# ���0 5 7 9 5� <br /> OTHER COMPANY <br /> SIGMATURE 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,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilitles 81 dumpster;Site Work Permit for subdivisions/large projects <br /> COI�IMERCIAL Attach(3)complete sets of Build(ng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> I Minimum ten(10)working days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1�dumpster.Site V11ork 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 /> Directions: <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of application,notarized <br /> if over�2500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> •" Agent(for the contractor)or Power of Attomey(for the ovmer)would be someone wlth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIot/Suroey/Footage) <br /> Driveways-Not overCounter if:on public roadways..needs ROW <br /> � :,:. . ,_ .. � � <br /> , ir. ' <br /> ,....� .. , . - i; <br /> L <br />