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813-780-0020 City of Z6phyrhills Permit Application Fax 81 3-780-0021 <br /> Building Department <br /> Date RecelVed Phone Contact for Permitting F( <br /> .............r1rr'rM rTT71rrrrrrrTT� <br /> Owner's Name Vincent- Hpi(na"indez; Owner Phone Number <br /> Owner's Address qq32 Oe4ll 151,/el "i WV"'-3S 691 Owner Phone Number <br /> Fee Simple1itleholder Name Owner Phone Number <br /> Fee Sirnpld'Titleholder Address <br /> JOB ADDRESS r 2 G \.Id rH -3 0 '354 1 LOT# <br /> SUBDIVISION PARCEL ID#1 - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR APDIALT Q SIGN DEMOLISH <br /> e- INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION O,e LOCK'J <br /> STEEL <br /> DESCRIPTION.OF WORK - ram( e q" JW 12-o Er <br /> 'BUILDINGiSIZE SQ FOOTAGE HEIGHT <br /> =BUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> ENLECTRICAL $ 5_00 AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING <br /> 1$ <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION. <br /> =GAS Q ROOFING 0 SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA AYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN LILN J <br /> Address License# <br /> 0 qatt <br /> V-7vs-+ <br /> ELECTRICIAN COMPANY <br /> SIGNATURE -REGISTERED YVN FEE CURREN <br /> t_-c 0 6 0 3L 5--)D Address, License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED -Y/ N': FEEtURREN L_Y.LN_j <br /> Address License <br /> MECHANICAL <br /> COMPANY <br /> SIGNATURE REGISTERED YJ N. I +FEE CURREN <br /> Address License#T <br /> OTHER COMPANY <br /> -SIGNATURE REGISTERED Y/ N .,FEE CURREN <br /> Address License# <br /> .............. <br /> ............. <br /> RESIDENTIAL Attach, sets.of Building Plans.(I.)set of Energy Forms;k- -VNP6rtniifo'r.neW onstrucdon,., <br /> Minimum tdri,04w'orklh6`days after SUbmittal',date.-Required onsit6i Construction Plans,Stormwater Plans wt Silt Fence installed, <br /> Sanitary Facilities&I dumpster;Site Work Permit for subdivisi6nsAarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a U i fe-Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> MInImurn'ten(10),Wgridrig.days after submittal+date...Required.ansite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary.Facilities&I dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2yaiits otEngineerid Plans., <br /> 11-PROPERTY.,SLIRVEY required for all NEW construction. <br /> .............. ....... ............. <br /> Directions: <br /> Fill'oUt application completely. <br /> Owner&Contractor.st§n,.back.of application,.notarized <br /> If over$2600,a Notice of.Commencement Is required. (A/C upgrades over$7500) <br /> Agent'.0or the contrActor)'Or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> `OVER-THE-COUNTER PERMITTING .(copy of contract required) <br /> itooft 4f shingles Sewers Service Upgrades A/C Fences(PlottSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />