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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-002i <br /> Building Department <br /> Date Received � 1 V Phone Contact for Permitting <br /> -rrrrrt.r........ ...... MMT <br /> Owners Name 1. t l.U0v 0 0 Owner Phone -77 9 <br /> Owner's Address '13a33 39855 3)83-7, 3M 39 Owner Phone Number F <br /> 'c-y <br /> Fee Simple Titleholder Name Owner Phone Number <br /> .Fee Simple Titleholder Address <br /> JOB ADDRESS Fucalgto-3 C)r - LOT i <br /> SUBDIVISION I ' Oof4ui oc)O� A 1 PARCEL <br /> -6316 Xo-611 o <br /> '(OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR a ADD/ALT E�fT SIGN MOVE DEMOLISH <br /> R . INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER P <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL OTHER I <br /> DESCRIPTION OFVORK. I+tW. rA2 (--C-(O&P (0539 Co A FTm b'd 1"(4 wpho 5 (L Un bfa <br /> f <br /> BUILDING SIZE. oo sQFOOTAGE L HEIGHT <br /> BUILDING D.C>b VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.( <br /> PLUMBING $ <br /> VALUATION OF MECHANICAL INSTALLATION MECHANICAL $ N <br /> 1 <br /> GAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS- FLOOD ZONE AREA AYES =NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N J FEE CURRENT <br /> Address License# <br /> F <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> OTHER -, COMPANY 6 0 01 To(- <br /> SIGNATURE+�, REGISTERED I IfYh N I FEE CURf(ENT I W/N <br /> ( <br /> Address 3-9- sq ADA ' (013 ri `535�1 1 License# [CCC-la 5 565 <br /> RESIDENTIAL Attach,(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction'. <br /> Minimum ten(16)working days after submittal date. Required onsite,Construction Plans,Stomiwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisio I ns/large projects <br /> COMMERCIAL. Attach(3 sets ofbuiidIng Plans;(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 meet compliance <br /> SIGN PERMIT Attach(2).sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> ................................. ....... ..................... <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 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 /> Rer?ofs_ ....,_,Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> �.�,ljnvewayS-Not over Counter.If on public roadways..needs ROW <br />