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City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting-.-I 513 7 q�L ------ <br /> LLLLL-ULLL3 Nil... <br /> -T w O -Owner Phone NumberOwner'ss Name mes wr <br /> Owner's Addressiq 0,00 a) C aeS5 S+ Owner Phone Number <br /> Fee Simple Titleholder Herne- Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS cw` LOT a <br /> SUBDIVISION en -PARCEL ID#13y-aLQ -a1 - CQq0 - QQ0X -03 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTRR ADDIALT' SIGN- DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED%USE 0 SFR COMM. OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQFOOTAGE=1 HEIGHT <br /> UW444" 4 <br /> =BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION <br /> [ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> [PLUMBING huw-w i. <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> [ GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ®YES NO <br /> ................. <br /> ............... <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN L_ILN LJ <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y I N:] _ FEE CURREN <br /> Address License# <br /> PLUMBER COMPANY end lf-�(t W <br /> SIGNATURE REGISTERED Y/-N FEE CURREN L_YM J <br /> Address <br /> License# IL,5S7 -oq a a <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED I­Y/ N FEE CURREN <br /> Address License# <br /> OTHER COMPANY ' r <br /> SIGNATURE REGISTERED Y/ N­ FEE CURREN <br /> Address 1 .L lcbnse# F- <br /> 4+H"+Hl <br /> i+Hi+M+5fIA1I1i <br /> RESIDENTIAL Attach-(2)Plot,Plans;(2)sets of Building-Plans;(1)sbt of Energy Foims;R-OW Permit for now construction,. <br /> 'Minimum ten(.IQ)working days after submittal-date.,Required onsIte,vCohstructIon:PIans-..StoryriwatefOlains w/Silt Fence Installed, <br /> Sanitary Fatilitles,&I dumpste!-,-;3Ite Work Permit for subdivislonsliarge 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 construction. <br /> Minimum-ten(10)working dayv after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&I 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 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 /> to Agent(for the contractor),or Power of Attorney(for time owner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER PERMITTING .-(Front of Application Only) <br /> Rerooft If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter If-,on public roadways..neeft ROW <br />