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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 Permitting <br /> .............. <br /> Owner's Name Owner Phone Number <br /> Owners Address I l Owner Phone Number <br /> Fee Simple Titleholder Home Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS cr-�)LO-_Q MDAden AATI�a_0 D(- LOT# <br /> SUBDIVISION PARCEL IDI 00000- D <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED:USE sFR 0 COMM- OTHER I <br /> TYPE OF C014STRUCTION BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK o/) <br /> BUILDING SIZE SO FOOTAGE=, HEIGHT <br /> �444 M4444444-14 1 <br /> BUILDING VALUATION'OF TOTAL CONSTRUCTION <br /> ]ELECTRICAL 1$ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> hA <br /> [3]PLUMBING <br /> T_ 1$ 00 1. <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ®YES NO <br /> ............... <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED FEE CURREN <br /> Address License# F- <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> PLUMBER COMPANY hit flOo,+ihn <br /> SIGNATURE N-0h 6A REGISTERED Y/ N, FEE CURREN I Y I-N <br /> Address P0- I License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FFECURREh. -LYIN <br /> Address License#. <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED l' Y1 N_ I FEE CURREN N <br /> Address License# <br /> 4+H+"+ .......... <br /> RESIDENTIAL Attach(2).Plot Plans;(2)sets of Building.Plans;(1)set <br /> at of Energy:Forms;R-O-W Permit for now construction' <br /> MInImUMT ten-(.19)working days after submittal date.:Required onslW-Cohstructiom0lans,-Stormwat&Plans w/Silt Fence installed. <br /> Sanitary Facilities&.1.dumpster,-Site Work Permit for subdivisionsnarge projects* - <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.ROW Permit for new construction. <br /> Minimum ten(10)working days after submlttat date. Required drfeite,-C6nstrucfldri-Plans,Stbfm VatbfPlEihsW/SIIUFe-nddinstalled, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements.must meet compliance <br /> SIGN PERMIT Attach(2)s6ts of Engineered Plans. <br /> *—PROPERTY SURVEY required for all NEW Construction. <br /> 1' 11111011 N' loom 1-111 Rill 111-11 IN1111 I III NW <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 Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIT-TING .-(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-needs ROW <br />