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813-780-0020 City of Zephyrhills Permit Application r1ax-0 10-fou"W41 <br /> Building Department <br /> -0 <br /> Date Received 1, - f 9 Phone Contact for Permitting <br /> ................ <br /> - F43 /o/ <br /> Owner's Name CQ�Jllolo&rol rrad 104leemot, Owner Phone Number 7?'//13 <br /> Owner's Address Fs-eo/o 'o Owner Phone Number <br /> Owner Phone Number <br /> /111 A <br /> JOB ADDRESS 'L?90 l 0 LOT# <br /> SUBDIVISION PARCEL ID#[Sr- 2S oo 70,-00o6o . 0(0/0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRR ADDIALT SIGN DEMOLISH <br /> a INSTALL REPAIR <br /> PROPOSED USE Q SFR COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL �) /r� <br /> DESCRIPTION OF WORK ".�Azp <br /> V <br /> BUILDING SIZE SQ FOOTAGEF7(�� HEIGHT <br /> W44 <br /> BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL 1$ AMP SERVICE Q DUKE ENERGY 0 W.R.E.C. <br /> [PLUMBING $ <br /> 16MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING F� SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> "HHHHH"HiHIHIH! <br /> BUILDER COMOARY' <br /> SIGNATURE REGISTERED Y/ N FEE CURREN N <br /> Address I License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LILN_J <br /> Address _7 License# F— <br /> PLUMBER COMPANY L— I <br /> SIGNATURE REGISTERED Y/ N—i FEE CURREN L_YLN_l <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE 4'-�4 REGISTERED C ff.J N FEE CURRE 1091 N <br /> Address ?0/ /0-c- License# <br /> OTHER COMPANY E;;;;�: <br /> SIGNATURE REGISTERED FEE CURREN <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)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 Plan*sw/Silt 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.Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> 4,1= ........I.,I... ..............I <br /> Pq ------ ......... <br /> tlo <br /> '4 Dr <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 (copy of contract required) <br /> Rerool's if shingles Sewers , Service Upgrades A/C, Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways-needs ROW <br />