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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 Permittinit. <br /> Owner's Name Owner Phone Number <br /> Owner's Address I Li Owner Phone Number <br /> Fee Simple Titleholder Name. Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ',�Wdk PCAkn oaq LOT 0 <br /> SUBDIVISION PARCEL 09 1 -Q05CD-Q1'9_0j <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR ADDIALT � SIGN DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED,USE SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK +icn w4�4ou <br /> BUILDING SIZE SO FOOTAGE HEIGHT C� <br /> ' <br /> 11 1 M44444444444 <br /> =BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY W.R.E.C. <br /> I t PLUMBING .1$1500.00 <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CUWE1, <br /> Address License# F` <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREh <br /> _L N_j <br /> Address License# <br /> PLUMBER COMPANY (on <br /> SIGNATURE REGISTERED I Y/ N. FEE CURREh <br /> Address 19 511 be-tylikelvivy) V�a Llcense# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I..YJ N I . FEE CURREh ILN J <br /> Address License <br /> OTHER CPMPANV <br /> SIGNATURE REGISTERED I- Y/ N_ FEE CURREN <br /> Address License'#-= <br /> ........................... <br /> RESIDENTIAL, Attach(2)PIdt-Plans;,(2)sets-of Bulldihd:Plans;(1)set of Energy'Fotms;R-P-W Permit for now construction, <br /> Minlmum,ten(19).wqrking.days after submittal data.:Required onslta,:Cohstr6CVDfi,PIans,"Stormwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&.1,dumpstpr,-Slte,Work Permit for subdivisionsfiarge-projects <br /> COMMERCIAL Attach(3)compleWsets:of BulldI66 Plans plus a Ufa Safety Page;(1)set of Energy Forms.R-OW 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&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Englneire&Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> 111111KII Jill 1191 1 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 PERMIT nNG .-(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 />