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813-780-0020 City of Zephyrhills Permit Application Fax-81 3-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting, <br /> Owner's Name Owner Phone Number <br /> Owner's address I410kcAl") W Wp�eSS 'C4 I Owner Phone Number <br /> Fee Simple Titleholder Name' -Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Vadem Ow'?d Sv I LOT 0 <br /> SUBDIVISION c_c 'A k V NO CJ 0 PARCEL 11101, QD10 -ON 00 -0��di <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR ADD/ALT' SIGN Q 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED.USE Q SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE [_ I SO FOOTAGE HEIGHTf <br /> ...... W44+W444444444 <br /> 0 A 1 0 A 1 0 A 1 <br /> =BUILDING $ VALUATION'OF TOTAL CONSTRUCTION <br /> =ELECTRICAL Is AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> #PLUMBING <br /> [MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> [ GAS ROOFING SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ®YES NO <br /> I ­11"Hiiii all + ........ ............... <br /> BUILDER COMPANY- I <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address Llcanse# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Ly <br /> L N_j <br /> Address Ucense# F <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y1 N. FEEcuRREN -Y/?f <br /> Address License# OD 33 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED L)=N - FEE CURRU <br /> Address License# F <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N.-T FEE CURREN <br /> Address License#-F <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building.Pla' ns'(1)idi of,Eniergy�Forms:R-O-W Permit for new construction, <br /> Minimum ten <br /> '(-jq)working-days after submittaidabi.-Required onslt4,-Const udon Plans;"Storrnwater-Plans wl Slit Fence installed, <br /> Sanitary Facilities&.1.dumpster,$IteWork:PermIt for subdivil.slonsilargeprojects <br /> COMMERCIAL Attach(3)complete'sets-of Building Plains plus,a Life Safety Pa.ge;(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/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 Englheerdd Plans.. <br /> 'PROPERTY SURVEY required for all NEW construction. <br /> MIND 111100"P11111, "11 <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. (A/C 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 /> DVER 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 if_onpublic roadways-ne'eds ROW <br />