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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department I <br /> Date 6teceiv.d � � � Phone Contact for P�rmitting (,� 7�`� -- b,5 3? <br /> Owner°s i�ame � � Ovuner Phone I�umber g►�'��- �9 �� <br /> Ouvner's�dc9ress �g63�j Ouener Phone fdumber <br /> �ee SBmple Titleholder idame Ouvner Phone Mumk��r <br /> Fee Simple Titleholder dlddress <br /> .co�a�D���ss �g�3S �� .�!�� �.ot� � <br /> SUBDINISIOId PARCEL iD# � � a�' �.(� m�� ��O�b� � O:L�O <br /> (OBTAIfdED FROM PROPERTY TAX NOTICE) <br /> WOR6f P6tOPOSED e NEw CoNSTR e ADD/ALT � SIGN 0 � DEMOLISH <br /> INSTALL REPAIR <br /> �ROPOSED USE Q SFR Q COMM 0 OTHER <br /> TVPE OE COMSTFtUCT10R'I Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPgIOR!OF WORK <br /> �UILDIWG 51ZE SQ FOOTAf:'E 3� 91�IGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY � W.R.E.C. <br /> �PLUMBING $ �� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIOfV � � <br /> � � <br /> OGAS Q ROOFING ,� SPECIALTY C] OTHER <br /> FINISHED FIOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDIER COHAPAfdY <br /> SIGfd4\TURE REGISTERED Y/ N FEE CURREA Y/M <br /> c�ddress License# <br /> �LEC'PRICIdid COMPA�Y <br /> SIG�AYURE REGISTERED Y/ IV FEE CURRE� Y/N <br /> AddPess License# <br /> ��u����a cort�Pn�v <br /> SIGiV�►TU92E REGISTERED Y/ N FEE CURRE� Y/IV <br /> Address License# <br /> MEC9iAR91CAl. CO�IIPAfdY <br /> SI(zW�TURE REGISTERED Y/ f� FEE CURRE� Y/N <br /> Address License# <br /> � <br /> OTF{ER CORAPAMY <br /> SICxWt��TURE REGISTERED Y/ IV FEE CURRE� Y/N <br /> Address 3 ZS��e ��-B^2 �i°� d!J-C License# CCC.—O�`7� Z. <br /> RESIDEV�TIAL 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 Facilitfes�1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMME9ZCIAL 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/Silt Fence installed, <br /> Sanitary Facilities�1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGfd PEBtf1AIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of appiication,notarized <br /> If over 52500,a Motice o6 Commencement is required. (A/C upgrades over$7500) <br /> '° Agent(for the contractor)or Power of Attomey(for the owmer)would be someone with notarized letter from owner authorizing same <br /> O!/ER TEiE COUPITER PERMiIYTIIdG (Front of Application Oniy) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-fVot over Counter if on public roadways..needs ROW <br /> I <br />