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.. -��, <br /> a�s-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> Date Received � �p p���� Phone Contact for Permitting �� � ( v — � `�� <br /> � 1 1 � 1 � � � 1 1 � � 1 <br /> Owner's Name ��l n� ��'��z���� Owner Phone Number �p�'�" a'tl � �� �� <br /> Owner's Address � �� � � u�� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> _ , <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � u� °� � ��� �. � � "'� �� tl� � 1, �� J�f� LOT# � <br /> � SUBDIVISION PARCEL ID# " <br /> (OBTAINED FROM PROPERTY.TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT 0 SIGN 0 � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR 0 COMM 0 OTHER <br /> TYPE OF CONSTF'tUCTION Q BLOCK Q FRAME 0 STEEL_ Q <br /> DESCRIPTION OF WORK � C �� L1 ' �� " � I�U1 ��Q� �� C�l� ��C��C i � <br /> BUILDIPIG SIZE SQ FOOTAGE� HEIGHT , <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> OPLUMBING $ 3 <br /> , ��-Z� <br /> �`MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br />! o� J0 •,5�?`� <br /> OGAS 0 ROOFING Q SPECIALTY � , OTHER � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA OYES NO � ��� <br /> . , . , ,_. . <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE 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# <br /> ` �.��:�.��an LLC <br /> MECHANICAL� MPANY � � I �L� �`�f � <br /> SIGNATURE __ �ISTERED N FEE CURRE� Y/N <br /> Address �Sqy� 5$o„�e ��_ 5� License# �—d1L� � �� 1910 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIItllllllllltlltllll_Itttllltllttllllllllllltltllllllllllllll <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 w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COPVIMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(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 w/Siit 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 /> . ._. . . . _. <br /> Directions: � <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> *' Agent(for the contractor)or Power of Attorney(for the owneP)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 A/C �Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW � <br />