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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-OD21 <br /> Building Department <br /> Date Received Phone-contact for Permlifing. TI iS� <br /> 043jax nrrrT11ffF?rrrT1rf.TVTTrrvrm P A I I-A A. 0............ ........ XZ112=1 <br /> Owners Name Lis Owner Phone Number <br /> Owner's Address ly Lon—) U) G I Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS mi 1 Y Y LOT 0 <br /> SUBDIVISION R,,Ldem PARCEL IDffij(9+aW_aj -(D10D- CCCGD- J'aYQ) <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT' SIGN DEMOLISH <br /> , R INSTALL 8 REPAIR <br /> PROPOSED:USE SFR F-I COMM OTHER <br /> TYPE OF CONSTRUCTION tQ1f <br /> BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK kn:5�2 u <br /> BUILDING SIZE 'VSQ FOOTAGE= HEIGHT <br /> =BUILDING $ <br /> VALUATIONOF-TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING <br /> n.500. ou <br /> MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> =GAS 0 ROOFING -.F__j SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> P. ..............I+ <br /> .. ............. <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LjLNLj <br /> Address License# <br /> ELECTRICIM COMPANY <br /> SIGNATURE REGISTERED FEE CURREN <br /> Address License# <br /> r <br /> PLUMBER COMPANY ULM L11 A I <br /> SIGNATURE �01 JA REGISTERED Y/ N• .- FEECURREN_- Y <br /> Address Ucense#-I 33a <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y1 N FEECURREK: <br /> Address License# F <br /> OTHER COMPANY, <br /> SIGNATURE REGISTERED Y I N-T FEE CURREN <br /> Address License#-F_ <br /> ............................................................. ........................................ <br /> RESIDENTIAL Attach(2)Plot,Plans' -Bulklifig.Phin s;(1)i4of Energy <br /> (2)sets of nergy,Forrns;R-O-W Permit for now construction, <br /> Minimum,+ten(19)workingdays pfter,sutirfitttal-daW.,-Required onsita,'CobstructlomPlans.,Stormwater Filains w/Slit Fence Installed, <br /> Sanitary Facilities,&1,dumpster,11te Work Permit for subdivisions/large pMects <br /> COMMERCIAL Attach(3)complete sets of Building Plains plus Life Safety Page;(1)set of Energy Forms.ROW Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all now projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)'sets of Ehgfn6ere-d Plans. <br /> ****PROPERTY SURVEY required for all NEWconstruction, <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 coniractor)'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 Ifon public rosoways..n6edi ROW <br />