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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for PermItUnW <br /> u l <br /> Owner's Name es Owner Phone Nrnbar <br /> Owner's AddresslHW(D U3 0 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number C I <br /> Fee Simple Titleholder Address ­71 <br /> JOB ADDRESS 3m- LOT 0 <br /> SUBDIVISION Rmey) vsy ---Q <br /> PARCEL ION H 01 DD OC �Q- C)-'19 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED R NEW coNsTRR- ADDIALT SIGN- DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME STEEL <br /> ri <br /> DESCRIPTION OF WORK L N04�AQ 1) , <br /> BUILDING SIZE SQ FOOTAGE HEIGHT L <br /> ................ <br /> ®BUILDING VALUATIONOF TOTAL CONSTRUCTION <br /> , $ <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING <br /> 4 1$ <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED FEE CURREN <br /> Address License# F- <br /> ELECTRICIAN. COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREh LILN J <br /> Address License# <br /> PLUMBER COMPANY mdey5on \MW, +( <br /> SIGNATURE REGISTERED Y/ N 1. FEE CURREN I '-YIN <br /> Address Ll 5 11 License#* I ut&CqQ5 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED J.-YIN I • FrEcuRREN- -LXLNJ <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED FEE CURREN, <br /> License# <br /> Address F <br /> ................................... <br /> HHHHHH*... Hl I I I I I I I I 1 6 11111 ......... <br /> RESIDEN71AL Attach(2),Pldf-Plans;(2)Sets.of Bulldihg�Plans;(1)Set of Energy Fortes;RO-W Permit for new construction_ <br /> si -'C6hs' m Plans-Stowater*13tans rm w/Silt Fence installed,Minimum,.te�(IO)wqrking,days-after,siibrhiftldat6.�R6461redon' t6, tructio <br /> Sanitary Factlit'las&1-.durnpster,,ZIte Wank Permit for subdivisionsAarge 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 wl 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(2)'sbtsof Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> 1111111P1111.1. 1 10.11 pall- 14-IIIN13 11 1 <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$7500) <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 If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter If on public rceoways-needs ROW <br />