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e�saeo-oozo Ciry of Zephyrhills ermit Application Fax-813-780-0021 <br /> Buiiding De artment <br /> Date Received Phone Contact for Permltting <br /> Owners Name � i Owner Phone Number � O � lJrtJ-� <br /> • Owner's Address I Owner Phone Number <br /> i <br /> Fee Slmple Tltleholder Name Owner Phone Number <br />' Fee Simple Titleholder Address <br /> JOB ADDRESS C3V �I l !I` � ��� I LOT# � <br /> 1 /'� 1 `� <br /> SUBDNISION ) v PARCEL ID# -O( �VO 7 � <br /> (OBTAINED FROM PROPERN TAIC NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN Q Q DEMOLISH <br /> , INSTALL e REPAIR �j'�'� � <br /> PROPOSED USE p SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ��1� r � I�� 1� l�-� JJ�C,C, �'m� <br /> c�J er <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION OF OTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ��/� <br /> �PLUMBING $ '`_ ) <br /> T r l <br /> QMECHANICAL $ VALUATION OF ECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZO E AREA DYES NO <br /> � <br /> • BUILDER �//�`� ��/�/� COMP Y f'll C�.t� �c)d er5 , I� 1V <br /> SIGNATURE d� J REGIS7 ED Y N FEE CURREA Y y N <br /> Address �4� � � � �I � License# �/ <br /> ELECTRICIAN COMP Y <br /> I SIGNATURE REGIST RED Y! N FEE CURRE� Y/N <br /> Address License# <br />' PLUMBER COMP Y <br /> SIGNATURE REGIST RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMP Y <br /> SIGNATURE REGIST REO Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COM Y <br /> SIGNATURE REGIST RED Y/ N FEE CIJRREA Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllltllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding Plans;(�)set of nergy Fortns;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days after submittal date. Requ red onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster;Site Work Permit for sub ivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safe Page;(1)set of Energy Fortns.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Req red onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster Site Work Pertnit for all n w projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW constructi n. <br /> Directions: <br /> Fili out application completely. <br /> Owner&Contrdctor sign back of application,notarized <br /> • .• If over$2500,a Notice of Commencement Is requlred. (AIC upgrad s over 57500) <br /> Agent(for the contractor)or Power of Attomey(for the owner)would be omeone with notarized letter from owner authorizing sama <br /> OVER THE COUNTER PERMI7l1NG (Front of ApplicaGon Only) <br /> Reroofs if shingles Sewers Service Upgrades AIC Fences(P otlSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..neads ROW <br />� <br />