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813-780-0020 City of Zephythills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received I I q-1 a I Phone Contact for Permitting <br /> Owner's Name Owner Phone Number <br /> Owner's Address L4000 W C Owner Phone Number <br /> Fee Simple Titleholder Home- Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Nuol '251\\XVQAd0 MOCh bi Vd 0, LOT 9 <br /> SUBDIVISION CJ 1 U 660 0 —7'1 PARCEL 10#105 R 1 00-4.) - Co5oo-CoNj <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED e <br /> NEW CONSTRR- ADDIALT' SIGN- DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSEM-USE -,SFR F-1 COMM- Q OTHER <br /> TYPE OF CONSTRUCTION -BLOCKQ FRAME STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SO FOOTAGE HE16HT C _�� <br /> =BUILDING $ VALUATION'00f6TAL CONSfk6CTIO-N <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> 16PLUMBING <br /> 1$ 150 0 • <br /> 00 t <br /> =MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> "GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> ....... ..................... H44*H+ <br /> BUILDER =MPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN L <br /> Address License# <br /> ELECTRICIAN --COMPANY <br /> SIGNATURE REGISTERED Y N FFEcuRREh--- L--Y/_N-j <br /> Address Licenses <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y L N. FEE CURREN Y/1 N <br /> # [�SS .— <br /> Address _11cense. <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED -Y N FEE CURREN. UL_Nj <br /> Address <br /> License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Address Lidense# <br /> It <br /> RESIDENTIAL-.,. Attach(2)Pidt-Plans;(2)Sets,d1fulldin,Plant;(1)44 of 9 I'argy-Forms;R-O=W Petraill:for how construction, <br /> Mlnlmum.IpR_(1.9),workirIgdays-after submittal date..Required onsiti;tbniisk"on.Plans;Sto rmwater"Pla'ns w/Slit Fence installed, <br /> Sanitary Faplllgeq:&.-I�,duMpste;-,.lSlte Work,Peffnit for subdivislonsfiarggprojects <br /> - <br /> COMM RCIAL Attach(3)complete sets of Building Pkinsipius-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 wl Slit Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all news projects.All commercial requirements-must meet compliance <br /> SIGN PERMIT Attach-(2)adts of Engirieer6d-Pliris. <br /> ****PROPERTY SURVEY re qq1r#d for all NEW construction. <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. (AfC upgrades over$7500) <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 if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over counter if.,on public roadWays..n-e eds ROW <br />