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a�saeo-oozo City of Zephyrhills Permit Applicatio Fax-813-7 02� <br /> Buildin�Department <br /> I ' <br /> Date Received _ � <br /> Phone Contact fo Permittin -- <br /> Owner's Name r (.�� (� li Owner mber <br /> Owner's Address °3 e Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number �— <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS U � �� i 1(�` �,�' LOT# C� <br /> SUBDIVISION PARCEL D# � � �' �(p (7 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME [� STEEL Q <br /> DESCRIPTION OF WORK `� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING a VALUATION O TOTAL CONSTRUCTION <br /> �ELECTRICAL $ � AMP SERVIC [� PROGRESS ENERGY Q W.R.E . <br /> C.�Dz l�s �� <br /> QPLUMBING $ � CS ` �Q�,�, ,�,(�-(„S� <br /> ��, ��--� �(�'`��,,'p G� <br /> QMECHANICAL $ VALUATION O MECHANICAL INSTALLATION C�. ,,�afp�M�" V <br /> �'v � ��e <br /> QGAS Q ROOFING Q SPECIAL Q OTHER .� (�(� � <br /> I '� L/� <br /> FiNiSHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO � � <br /> � � <br /> BUILDER COM ANY <br /> SIGNATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN , ��` COM ANY � I l(,l.X ��C <br /> SIGNATURE REGIS ERED Y I N FEE CURRE� Y/N <br /> Address License# 5 J <br /> PWMBER � COM ANY <br /> SIGNATURE � REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COM ANY <br /> SIGNATURE REGIS ERED Y J N FEE CURRE� Y/N <br /> Address license# � <br /> OTHER COM ANY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Piot Plans;(2)sets of Building Plans;(1)set of nergy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days aRer submittal date. Req ired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles&1 dumpster;Site Wo�lc Petmit fo�sub ivisfonsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Build(ng Plans plus a Ufe Safeky Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days atter submittal date. Req�ired onsite,Constructlon Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Wor1c Permit for ali niew projects.All commercial requirements must meet compliance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. <br /> •'""PROPERTY SURVEY required for all NEW constructiqn. <br /> Directions: I <br /> Fill out appiicaHon completely. I <br /> Owner&Contractor sign back of application,notarized I <br /> If over 52500,a Notice of Commencement is required. (AIC upgrad�s over=7500) <br /> "" Agent(for the contractor)or Power ot Attomey(for the ovmer)would be�omeone 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(Pibf/Survey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW � <br /> �I <br />