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r— — , <br /> . � I . <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � • � � � Building Depiartment <br /> Date Received Phone Contact for Permitting — <br /> -. - . ..,,,..., ,,:.� -=-s. �.,.,,W-; - . ,�„ .,�.- - -- -- --- _ - <br /> Owner's Name li � � Owner Phone Number � —�� "f`' <br /> Owner's Address ' Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> ' • I <br /> Fee Sirriple'Titleholder Address ' <br /> JOB ADDRESS LOT# � <br /> SUBDIVISION `�S PARCE�L ID# � ` � �Ol �—�v1 b�V�/ 1 W` v <br /> (OBTAIN D FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR � ADD/ALT Q SIGN Q MOVE � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION � BLOCK � FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK �"�. �J �� � I ��J � C1� � <br /> BUILDING SIZE SQ FOOTAGE O J I HEIGHT <br /> �,^^^ - - - <br /> D�m BUILDING $ � VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> Q PLUMBING $ • �`Y! <br /> �� <br /> Q MECHANICAL $ /��y � � VALUATION OF MECHANICAL INSTALLATION � <br /> C�J 1J U <br /> 0 GAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES QNO <br /> �� � ��� .�, _ � . ����� <br /> � SUILDER- — - C�iJiPANY-- -- - - - - - - - — - - <br /> SIGNATURE I REGISTERED Y/ N FEE CURRENT Y/N <br /> I <br /> Address ' I License# <br /> ELECTRICIAN C�MPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE _ � REGISTERED Y/ N FEE CURRENT- Y/N <br /> Address I License# � <br /> � � <br /> MECHANICAL / <br /> SIGNATURE � I �r � G�� C�G�jsPE ED Y/ N FEE C RRENT Y/,N <br /> Address �� � �" I License# r "I / <br /> OTHER r CI MPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> I <br /> Address I License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms <br /> Mmimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster <br />_ COMMERCIAL___Bttach(3)seis_of Building_P_lans;(])_set of Energy-Forms. I — - - —--- --__ -----—- - - ---- <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster <br /> All commercial requirements must meet compliance. � <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. � <br /> '*`"PROPERTY SURVEY required for all NEW wnstruction. <br /> s�c r � m�aa m�er� aeaA - ��a��.ea a o�� �',P�r�'-i.'�r,_��-� - rcaa� ;�pw.m zr.sa�i¢� y,r 's r c° �:,xaw ��z x�e � �w�x�i <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized , <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$5000) <br /> *' Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />