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� <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ' ' Building Department <br /> Date Received /f � /��) �1 ,/�i P� <br /> K� � '(1— I Phone Contact for Permitting 7 7/ 7' � — 7 7 �8 <br /> 1 1 1 1 1 1 1 1 1 1 1 i 1 <br /> Owner's Name � PS A r.�! R- Owner Phone Number S�3' ?�bg— ��7 � <br /> Owner's Address a Q�j /O �/L Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��a� OR l0 +� LOT# � � <br /> SUBDIVISION /'� 'Q /�/� PARCEL ID# (�3—o��—"a I� d/ �' o(�(�(7� — ��30 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK I`�C�VQR 'F'�1Q Of3�IQ /�O»1P ('pOI� � �qNq� 1'�0� � �'/� T O g i9iQq� ynoF► <br /> BUILDING SIZE �Yx `�9 �X13 a�1X�3 SQ FOOTAGE I�� I HEIGHT ' <br /> QBUILDING $ /� �Cj/� •O� VALUATION OF TOTAL CONSTRUCTION � ��'a� <br /> �O l�v <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.0 <br /> QPLUMBING $ � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ���' 'P�a�' <br /> � <br /> QGAS �J ROOFING Q SPECIALTY � OTHER ��C <br /> \.:/ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER � o �COMPANY (`� Q<}'�1�Q� �Nfi� ��S�.�1LG� <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 3��Y1 8' �T �'. �ao� P�4CAdp,�vT9N 3y>II License# CC� �'S�07S <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 /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <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 /> COMMERCIAL Attach(3)complete sets of Building Plans plus a L:�e 3afety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum tPn(10)workfng days<^.fter s�bmittal date. kequired onsite,Const u�tir.n Plans,Storrrwater Plans w/Si1c Fence ir�sialled, <br /> Sanitary Facilities&1 dumpster Site Work Permit for all new projects.All comriercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> *""PROPERTY SURVEY required for all NEW construction. <br /> Dtrections: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized <br /> If over s2500,a Notice of Commencement is requlred. (A/C upgrades over s7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITIING (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 />