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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department � <br /> i� <br /> Date Received Phone Contact for Permttting ��� 2$2 — �3 C <br /> Owner's Name � � ' Owner P one Number <br /> �,1 / �l /�q 9��L <br /> Ovuner's Address �1��. r5/(�-� L� U� v`�`Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Slmple T(tleholder Address " <br /> JOB ADDRESS a 3 I'2 J + LOT# �� <br /> i SUBDIVISION PARCEL ID# �� %zC� f� '��� —Q(1 J�OC� �D O CJ <br />� --- --- - --- - --- - --- - - --- -- -- (09T.41MED-FROlLl�RO^ERT-Y-T6XNO71C�)-------- ----------- -- <br /> WORK PROPOSED NEW CONS7R ADD/ALT �� SIGN Q Q DEMOLISH <br /> e INSTALL e REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> T1fPE OF CONSTRUCTION Q BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK �� ��e �j(� ��tn C Jj/-�4 �� <br /> BUILDING SIZE ' SQ FOOTAGE� HEIGHT <br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> LECTRICAL $ — AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> �5 �5� � . CI <br /> QPLUMBING $ '`-�U� � � <br /> Sg� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �' 1 <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAfd G_ �B7r„ COMPANY 2 f� <br /> e-cC �' l� -�/'�y LG <br /> SIGNATURE iLGt-(� REGISTERED Y/ N FEE CURRE� Y/M <br />' Address License# �� DD -�- <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 L(cense# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construcdon, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster;Site Work Permft for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcGon. <br /> Minimum ten(10)working days after submittal date. ReGuired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> San(tary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out applicaUon completely. <br /> Owner&ConVactor sign back of application,notarized <br /> If over�2500,a Notice of_Commencement is required. (A/C upgrades over 57500) <br />� � , ..� _ <br /> '• Agent(for the contractor)or Power of Attomey(for.the owne�);viioulil be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING -`,,.(Fr,onYof�Application Onlyr)r <br /> Reroofs if shingles Sewers ;-,-.Service'Upg'rade"s A/C'�...�`Fences(PIoUSurvey/Footage) <br /> �: .� ._.._,__ ., .r ' �. � ; <br /> Driveways-Not over Counter if on public roadways..needs�tOW'" <br />