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813-780-0020 City of Zephyrhills Permit Application Fax-11134WO021 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> Owner's Name Owner Phan Number <br /> Owner's Address HUD) W Owner Phone Number F- <br /> Poo Simple Titleholder Name Owner Phan*Number F <br /> Fee Simple Tillahaider Address <br /> JOB ADDRESS Litt t.R LOT 0 <br /> SUBDIVISION M-5-cW- PARCEL IDS -@.I <br /> (OBTAINED FROM PROPERTYW(NOTICE) <br /> WORK PROPOSED NEW CONSTitR. ADD/ALT- SIGN, r7 DEMOLISH <br /> - R INSTALL REPAIR <br /> PROPOSED USE SFR F-1 COMM OTHER I <br /> TYPE OF CONSTRUCTION QS <br /> BLOCK j Q FRAME Q STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQFOOTAGE= HEIGHT <br /> "44444" <br /> =BUILDING ' VALUATION OF TOTAL CONSTRUCTION,- <br /> =ELECTRICAL f$ AMP SERVICE 17-7 PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING <br /> # 1$1 ULM W1- <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> 111111 H+H+H+144+14+ <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURREII LILN J <br /> Address License#F- <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURRM N <br /> Address Uoense@F— <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/N. FEECURRM Ylf <br /> Address r 1 bQ4-NOI-e-m P0. 71 license#T75-5-7 <br /> MECHANICAL I COMPANY <br /> SIGNATURE REGISTERED I Y1 N FEE CURM YIN_J <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I YJ W. FEE CURREN L.XLN J <br /> Address U can Ga#:F— <br /> ........... <br /> RESIDENTIAL Attach(2)PioWlans;(2)sets al'bulkling-Plains-,(1)'set of Energy Forms;k-O-W krmlt for new construction, <br /> Minimum.ten(10)working Jaya aftersubmittaidate.:Required onsIta,Construction Plans,Stormwater Plans w/Bill Fence Installed, <br /> Sanitary Facilities&.I.dumpaten Site Work Permit for subdivislonsfiarge prclects . <br /> COMMERCIAL Attach(3)cornptew sat§of Building 01"plus a 1111e'Safely,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 wl 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 Engineered Plans. --- <br /> -PROPERTY SURVEY required for all NEW constriction. <br /> D onw. <br /> Fill out application completely. <br /> Owner&Contractor Sign back of application,notarized <br /> Never$2500,a Notice ofCommancomont Is required. (A/C upgrados over$700) <br /> Agent(for the contractor)or Power of Attorney(IcIr the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING . (Front of Application Only) <br /> Rorools If shingles Sewers SenAce Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drivoways-Not over Counter If onpublic roadways-needs ROW <br />