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813-78MO20 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin — <br /> "TTTTITT"I"' T"TT"v,T <br /> Owner's Name -IL Owner Phone Number <br /> Owners Address ar ^i Owner Phone Numhor <br /> Fee Simple Titleholder Name I Owner Phone Number <br /> Fee Simple Titleholder Address + 4 1 <br /> JOB ADDRESS 1 Y11,A 1. LOT# <br /> SUBDIVISION Qk.S PARCELID# —akf- QD3Q—CLID 0 <br /> (OSTAIt1ED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW t ONSTR 8 ADDlALT © SIGN Q = DEMOLISH <br /> INSTALL REPAIR <br /> Ei�PROPOSED USE = SFR = COMM 1^� OTHER <br /> TYPE OF CONSTRUCTION = BLOCK ` FRAME L� STEEL <br /> DESCRIPTION OF WORK ne e <br /> ci <br /> BUILDING SIZE O k 0 60 FOOTAGE® HEIGHT <br /> v BUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> 00-0.4 <br /> ELECTRICAL S DQ AMP SERVICE = PROGRESS ENERGY Q W,R.E.C. <br /> =PLUMBING S <br /> MECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY W10.A RwgAnileS <br /> SIGNATURE REGISTERED IUY N FEE CURRFA Y/N <br /> Address 3 3 license# 0 ria 0116105 <br /> ELECTMCI COMPANY e cf&t L <br /> SIGNATURE / REGISTERED Y N I FEE CURREA I Y I N <br /> Address aa5la License# <br /> PLUMBERF COMPANY SIGNATURE REGISTERED Y/ N FEE CURRO, I Y!N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED YIN FEECUMa Y!N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREr Y/N <br /> Address License# <br /> rrrrrrrrrrrrrrrrrrrlrrrrrrrrrrrrrrrlrrrrrrrlrrrrrrrrlrrrrrrrrrrrrrr <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(ID)working days after submittal date.Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsliarge projects <br /> COMMERCIAL Attach(2)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 days after submittal date. Required onsite,Construction Plans,Stonnwater 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 /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> It over$2500,a Notice of Commencement is required. (AlC upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Remofs If shingles Sewers Service Upgrades A!C Fences(Plot[Surveyff ootage) <br /> Driveways-Not over Counter if on public roadways needs ROW <br />