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� i � . � t <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building De artment <br /> Date Receiv�d q�I �!� Phone Contactt'or Per ittin — <br /> Owner's Name �� /r/ /� � �� Owner Phone Number <br /> Owner's Address �y�� ��� ��� �L Owner Phone Number <br /> Fee Simple TiGeholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3�� � L)�Q�d ��v�, � h h� (Is wL .335y� LOT# � <br /> SUBDIVISION PARCEL ID# 03 a�a�-oai Q�-�(p�QQ��QQQ(� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT SIGN [� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL Q <br /> DESCRIPTIONOFWORK ��• TIIU1�Ill1�w(�c� �Q�I �� � �l1� 'C B � (��lW�ni� �nYU�Y � ��]7 <br /> BUILDING SIZE O u1�F X O � W SQ FOOTAGE ��6� HEIGHT �� ��{�' <br /> QBUILDING $ . VALUATION OF T TAL CONSTRUCTION ��r �I�. <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> i� <br /> OPLUMBING $ ���j <br /> QMECHANICAL $ VALUATION OF M CHANICAL INSTALLATION �GJ` v <br /> QGAS Q ROOFING Q SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZON AREA QYES NO <br /> r <br /> BUILDER � �O Y � 1 e s►�n� �W h�ng ��C <br /> SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N <br /> Address (D 5 N• [�1e�4� ,Si'e7, Lutz FL 3�5 �icense# <br /> ELECTRICIAN COMPA Y <br /> SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPA Y <br /> SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPA Y <br /> SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPA Y <br /> SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N <br /> Address License# <br /> Illllllllllllllllllltllllllllllllllllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of En rgy Forms;R-O-W Permit for new consVuction, <br /> Minimum ten(10)working days after submittal date. Require onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivi ions/large projects <br />- COMMERCIAL - Attach(3)complete sets of Building Plans plus a Life Safety age;(1)set of Energy Forms.R-O-W Permit for new wnstruction. <br /> Minimum ten(10)working days after submittal date. Require onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Pertnit for all ne projects.Atl commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW canstruction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades ver$T500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would be so eone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoU urvey/Footage) . <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />