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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> Date Received ItUng- L) I <br /> Phone Contact for Permittin C(C <br /> &LLJJ44444.&= 2� <br /> ownses Name LC"M1 V, owner Phone Number <br /> Ownees Address voo W Cq&55 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS [M)a LOT 0 <br /> 4 <br /> SUBDIVISION JV�F] PARCEL IDN Ll-OW-al- 010 =L)- Cqq-p -1 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED e <br /> NEW coNsTR ADD/ALT- SIGN- DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED-USE Q SFR Q Comm OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q <br /> )n FRAME STEEL <br /> DESCRIPTION OF WORK LA-T <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> M 111111111A.2 In F.0111 i i P S P" <br /> ®BUILDING $ VALUATION OF TOTAL <br /> OTAL CONSTRUCTION <br /> RUCTION <br /> =ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> PLUMBING <br /> 1$ <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ®YES NO <br /> .........IIIIIHHHHH 111111!1111 111 A 111 11111 1 Him <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED FEE CURREh <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREh L_ILN�j <br /> Address License# <br /> PLUMBER COMPANY e1rd Lf:hn 1-moom"'M I <br /> SIGNATURE REGISTERED Y/:N. FEE CURREN- I uf/N <br /> Address Hbl I 'I It 6 1 cy)e M 'License# JL-�)S <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED YJ N FEE CURREN <br /> Address Ucense#.F <br /> OTHER "COMPANY <br /> SIGNATURE REGISTERED Y/ N., I FEE CURM <br /> Address License#- <br /> .............. .............. ............... <br /> RESIDENTIAL` Attach(2).PI6t.PIarW (1)set of-Eriergy�Forrns;R-iD-W Penn construction,t for now <br /> _(2)Sets of Building: iins;PI" � l ­­ <br /> minimum.ten(10)workingdays after s6binIttbI'daI6.;Required oniftd, wl Slit Fence Installed, <br /> Sanitary Facilities&.I.dumpster,Site Work.Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Bulklirig Plans plus a Life Safety Pa.gw,(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 new projects;All commercial requirements,must meet compliance <br /> SIGN PERMIT Attach(2)'SbtsofE6gIm34r6dPlans. <br /> 'PROPERTY SURVEY required for all NEW construction.. <br /> I, lopil.1111111.1 - 11 .1 ------I------------111111"1411111111 Will 111 11111111111111111119 I'llillix 11,11 <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. (AIC upgrades over$7500) <br /> Agent(for the 6ontraclor)'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 roadways-needs ROW <br />