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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building epartment <br /> Date Received, Phone Contact for ermitting -- <br /> Owner's Name 1 i JY� Ovener Phone Number <br /> Owner's/Address � ✓ h�� c�7 Owner Phone Idumber <br /> Fee Slmple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS .7 � LOT# � <br /> SUBDIVISION PARCEL 1 # <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NSTALLSTR B REP AL�T 0 SIGN Q Q DEMOLISN <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTIOId Q BLOCK FRAME � STEEL � <br /> ,p t <br /> DESCRIPTION OF WORK L �Lt C <br /> BUILDIPIG 51ZE SQ FOOTAGE HEIGHY <br /> OBUILDING $ VALUATION O TOTAL CONSTRUCTION <br /> [�ELECTRICAL $ �,v� AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � ��G� <br /> � <br /> OMECHANICAL $ VALUATION O MECHANICAL INSTALLATIOIV <br /> 2��� <br /> QGAS Q ROOFING Q SPECIAL 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD Z NE AREA �YES NO <br /> BUILDER COM ANY <br /> SIGMATUE2E REGIS ERED Y! N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAM COM ANY �'t/� O�',G <br /> SIGNATIDRE REGIS ERED Y N FEE CURR � Y/N <br /> Address � A � �G � � License# �G��Q�� � <br /> / <br /> PLUMBER COM APIY <br /> SIGNATURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHAMICAL COM ANY <br /> SIGNATURE REGI ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COM ANY <br /> SIGNATURE REGI TERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buiiding Plans;(1)set o Energy Forms;R-O-W Permit for new consUuction, <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflities 81 dumpster;Site Work Permit for su�divisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sa ty Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Re uired onsite,Construction Plans,Stormwater Plans wl Siit Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all ew projects.All commercial requirements must meet compliance <br /> SIGPI PERMIT Attach(2)sets of Engineered Plans. <br /> `""'PROPERTY SURVEY required for all NEW construct on. <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over�2500,a Notice of Commencement(s required. (A/C upgra es over$7500) <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 PERMITTING (F�ont of Application Only) <br /> Reroofs ff shingles Sewers �- Service Upgrades A%C , Fences( lot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..rieetls ROW <br />