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813-780-0020 City of Z.ephyrhills Permit Application Fax-813-78U-1)UZ1 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> -­--------- <br /> .............. ...... ....... <br /> Owner's Name c-, 0, Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Namel Owner Phone Nuniber <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 5 i LOT 9 <br /> SUBDIVISION PARCEL ID#1 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN MOVE DEMOLISH. <br /> e INSTALL REPAIR <br /> PROPOSED USE Q SFR COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL OTHER <br /> DESCRIPTION OF WORK Ab <br /> BUILDING SIZE SQ FOOTAGE HEIGHT F <br /> BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL 1$ AMP SERVICE PROGRESS ENERGY Q W.R.E.C, <br /> PLUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> GAS ROOFING 0 SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ YES =NO, <br /> evil 1 1,11211 st.11.3......I....... ......... <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address F License# <br /> ELECTRICIAN COMPANY I-y-, <br /> SIGNATURE E REGISTERED q_Yt)N I FEE CURRENT LZIN J <br /> Address _bQtkZ License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y�N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT NL] <br /> Address F_ License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <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(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&I dumpster;Site Work Permit for subdivisionsfiarge 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 days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&.1-clumpster.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. (AIC 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 /> Reroofs Sewers Service.Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over-Counter1fldn'pdb c-roa wqys..ne­'s' <br /> 'K <br /> V11 <br />