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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> Date ReceivedI Phone ContactL for Permitting' <br /> 3= ............... .........................r7jrl I 1= 7 <br /> Owner's Name 7 <br /> Owner Phone Number <br /> Owner's Address 0 1 wner Phone Number <br /> Fee Simple:Titleholder Name Owner Phone Number <br /> Fee Slmpie,Titleholder Address <br /> JOB ADDRESS l_5_0 6 LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONISTR ADD/ALT SIGN DEMOLISH <br /> e INSTALL a REPAIR <br /> PROPOSED USE Q SFR COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK 0 FRAME STEEL <br /> DESCRIPTION OF WORK a <br /> fv- <br /> w <br /> BUILDING SIZE SO FOOTAGE= HEIGHT <br /> - j <br /> 0. <br /> BUILDING 1$ <br /> VALUATION OF TOTAL CONSTRUCTION' <br /> =ELECTRICAL AMP SERVICE = PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> QDMECHANICAL <br /> -00,w VALUATION OF MECHANICAL INSTALLATION <br /> GAS 0 ROOFING Q SPECIALTY OTHER <br /> FINISHED!FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> ................. <br /> BUILDER is COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN, <br /> Address F License# F <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LYLN <br /> Address' License# <br /> PLUMBER- COMPANY <br /> SIGNATURE REGISTERED-• 1 ,Y1*N'­j FEE CURREN LKLN_j <br /> Address License# <br /> MECHANICAL COMPANY. [Aleov_-/2'f -1fpr_e 2.e 'C' <br /> SIGNATURE <br /> REGISTERED YJ N.T FEE CURREN <br /> Address License#' <br /> dd 'as A-)4 -Al <br /> OTHER COMPANY <br /> -SIGNATURE REGISTERED YJ N FEE CURREN <br /> Address License# <br /> 111_144,11�iiwll Hll III IIIIIIIIIH!-Hill!!!! I I I III HHH!1 H 1 H!1H!11111.!!HHIIIIII <br /> ........... ...c-6 r,66w.qoqstruct!on, <br /> iisiiiiNTIAL' A6 P' R- -W.4nnkfo''Building Energy F67s, <br /> Miniio'um t,6ii(�iOYWarl�'n'gdayi eift6r�sdbinittal dal:6:'Ri6q'ufred"ohsite,Cofisitruction-Plans;Stormwater Plans,w/Siit Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsfiarge projects <br /> Attach(2)complete sets of Building Plans plus a Llfe.Saf'ety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum tan(10)working.opys afte.r.submittal date.,.Reqpire id onsite,Construction Plans,Stormwater Plans w/Silt Farce installed, <br /> Sanitary.Facilities&I dumpster.Site Work Permit for all riew,projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> *7"PROPERTY.SURVEY required for all NEW construction. <br /> ................ <br /> ............. ---------------- <br /> Directions. <br /> Fill out application completely. <br /> Owner&'Contractor sign:back of applicaton,.notarized. <br /> If over$2500,a Notice of Commencement is required. (A(C upgrades over$7500) <br /> .,Agent#ot the contractor)or Power-of Attomay(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVItItTHEZOUNTER PERMITTING contract,required) <br /> Reidofs if shingles Sewers Servide-Up gradas--A1C­- --Fenc-6s(Plot(Stirvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />