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" a�sado-oozo City of Zephyrhills Permit Application <br /> Fax-813-780-0021 <br /> Building Department <br /> ' ,\ + '�l-� .'�'?l� . ��i3� <br /> Date Received � � a U��'! Phone Contact for Permitting — <br /> � aeee � �� ��� - 3�33 <br /> 0000t � oe <br /> ���r i� ` � �5 Owner Phone Number <br /> Owner's Name <br /> � �� C�,� � ti,� 'S-t', Owner Phone fdumber <br /> Owner's Adciress �--, <br /> Owner Phone Number <br /> Fee Simple Titieholder Naene <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS � <br /> 5�a�i r�� -�� �. 2� ►�� s 1. �3 s��� �oT# <br /> PARCELID# <br /> . SUBDIVISION (OBTAINED FROM PROPERTY TAX NOTICE) <br /> e NEW CONSTR e ADD/ALT <br /> � SIGN � � DEMOLISH <br /> WORK PROPOSED �NSTALL REPAIR . <br /> SFR Q COMM �� OTHER <br /> PROPOSED USE ' � FRAME � STEEL 0 <br /> TYPE OF COMSTRUCTION � BLOCK Q _ � <br /> DESCRIPTION OF WORK � � � ��� � � : <br /> BUILDING SIZE <br /> SQ FOOTAGEC� HEIGHT <br /> �BUILDING � . VALUATION OF TOTAL CONSTRUCTION <br /> _. �ELECTRICAL $ AMP SERVICE 0 � / <br /> PROGRESS ENERGY � W.R.E.C. <br /> � � v <br /> �PLUMBING $ ( � <br /> VALUATION OF MECHANICAL INSTALLATION � <br /> �MECHANICAL $ ���� ,., `y%%t%�� <br /> IS <br /> . �GAS � ROOFING Q SPECIALTY 0 . OTHER <br /> • FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> 1--1�1.°��..E <br /> GONYPANY FEE CURRE� Y/N <br /> BUILDER REGISTERED Y/ N <br /> SIGNATURE <br /> License# <br /> Address <br /> " COMPANY <br /> ELECTRICIAM REGISTERED Y I N FEE CURRE� Y/N <br /> SIGI�!/�lTURE • ' � <br /> License�P <br /> Address <br /> COMPANY <br /> PLUMBER REGISTERED ' Y 1 N FEE CURRE� Y/N <br /> SIGMATURE � <br /> License# <br /> Address ,n (� 1 <br /> ����c� 1`l�,r � C':It°;L�.l.;�,, �LC <br /> - COMPANY <br /> MECHANICAL ,-� RE�isTeReo Y N FEE CURRE� Y/N <br /> SIGNATURE 'L(� ``' j $�l� tq� <br /> .cy License# <br /> Address �J�j�`l�l:• �l a-�=�0�� � <br /> � � COMPANY FEE cuRREn Y/N <br /> OTHER REGISTERED Y/ N <br /> SIGNATURE <br /> License# I <br /> Address . <br /> g e g y � � � 1 1 1 1 n a o e e 1 t 6 � fl � � � e A�e Plans;(1)�set of Ener�gy Fo ms;R O W Perm t for new�construction,A � � ' � e � fl � 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buiid g <br /> Minimum ten(10)working dayefaSite WorkltPer�m teio s ubdiv sionsllarge�project on Plans,Stormwater Plans wl Silt Fence installe , <br /> Sanitary Facilities&1 dumpst, , 1 set of Energy Forms.R-O-W Permit for new construction. <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;( ) <br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Consfruction Plans,Stormwater Plans w/Silt Fence installe , <br /> Sanitary Facilities&1 dumpster.Site Woric Permit for all new projects.All commerciai requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pla�s. <br /> "*"*PROPERTY SURVEY required for all NEW constru fion. <br /> _� <br /> Directions: <br /> . Fill out application co 9pletely. p �ication,notarized <br /> Owner&Contractor si n back of a p� �C� r�des over$7500) <br /> If over$2500,a Notice of Commencement is required. ( p9 <br /> ^* Agent(for the contractor)�or Power of Attorney(for the owne�)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicalion Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C �Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> \ <br />