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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> Date Received Phone-Contact for Pormifting IcIal S 51 <br /> U <br /> Owner's Name Owner Phone Number <br /> Owner's Address L-1 Is Owner Phone Numberi <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Ef:))Lm mol 6-1 io ittlow Df LOT 0 <br /> SUBDIVISION PARCELIW13q-a O- 9t-D39D- C)()M- )- I)Dt) —1 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTRR ADDIALT SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED:USE Q SFR COMM OTHER I <br /> TYPE OF CONSTRUCTION QV <br /> BLOCK * 0 FRAME STEEL <br /> DESCRIPTION OF WORK n,2c&n11 <br /> BUILDING SIZE FOOTAGE HEIGHT <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING 1$la w, a) i <br /> ]MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS 0 ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ®YES NO <br /> .................I..................... H4++i+f...............44+1++++1* <br /> BUILDER COMPANY- I I <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED FEE cuwei, <br /> Address License# F— , <br /> PLUMBER COMPANY LU_Cnde_vLc)cn tv oa+ion I <br /> SIGNATURE REGISTERED I YV - 1. FEE CURREN I Y/W <br /> Address r)"i ieiiay) License# I L155- CAr L� J <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y=1N - FEECURREI,. <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License#F— <br /> I I H t ................... ...... ...HHHH ................H+H+ <br /> RESIDENTIAL- Attach(2)Plot,Plans;(2)sets of Building.Plans;(1)set of EnergVftrms;R-O-W ftmilt for new construction, <br /> Minimum ten(10)working days,after submittal-date.:Required onsIt6,-Cohstkuc#omPIans;.Stormwat6r Plans wl Silt Fence installed, <br /> Sanitary FacIlitlesA.1.dumpsteq SIto Work Permit for subdivisions,fiarge projects, <br /> COMMERCIAL Attach(3)complete sets of Building Plain's' plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements.must meat compliance <br /> SIGN PERMIT Attach(2)"sbts of Engheered'Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> gills, I M., 11M.11111-1111 11 1 1 11-1111 <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$7500) <br /> Agent(for the contractor)or Power of Attomey-(far the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER.PERMITTING .-(Front of Application Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if-on public roadways-neea ROW <br />