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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> • Building Department II Date Received <br /> Phone-Contact for Perniltting. ............ 02 5`7== <br /> Owner's Name—=,trV161Y -"DYMS Owner Phone Number <br /> Owner's Address co W Npreffi S� Owner Phone'Number <br /> Fee Simple Titleholder Name. Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS =5q0 l SOCOle- Palm !Mq LOT# <br /> SUBDIVISION PARCEL ID# W- 31 Dosoo —Ca�p <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR ADDIALT' SIGN- DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED,USE Q SFR Q comm. OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ'FOOTAGE=1 HEIGHT <br /> =BUILDING $ VALUATIOWOF TOTAL CONSTRUCTION <br /> =ELECTRICAL - AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> 4 PLUMBING <br /> 1 <br /> =MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> _1GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ YES NO <br /> ................... ......... HHHHH I fit H+H+H+ <br /> BUILDER COMPANY' <br /> SIGNATURE REGISTERED Y N Fer=CURREN Address T -License# F7-7 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FFECURREN - LjLN J_ <br /> Address License# <br /> PLUMBER COMPANY _Y45Dn �ff(0CA+1\0n <br /> SIGNATURE" REGISTERED YL N•- FEecuRREK L_y M <br /> Address v 1 h cm M, Limpet, <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED .1 Y/ N_J FEE CuRREh- <br /> - Addreas: License OTHER -COMPANY <br /> SIGNATURE REGISTERED TY/ N_- FEE CURREN Y 114 <br /> Address Lid6rise#1 <br /> 441"14+ +16111H"Hiii"HH HH HHHN............................................. <br /> RESIDENTIAL Attach Forms;F2=0=W'Peiirrlt for <br /> new corip"ptiqn., <br /> -Minimum leril1.0),vorkin --d after'subtfiltial-dat6.'Required on'siti�-'Cdiistrii6t(6i!'Pl�ins,Stormwater'Plans w!Siff Fence Installed, <br /> Sanitary Facilities,&_1;dumpster,•Site Work_9., ays <br /> tit for <br /> COMMERCIAL Attach(3)ob-6016te's-efs"61!BUIldifit(Plaiiis plus.a Life Safety Page,.-(i)Set of Energy Forms R-O-W.Permit for now 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 Attadk(2)'sdtsofEti f6.e6r.iic(,Pl;i6s., <br /> ****PROPERTY SURVEY required for All NEW construction.. <br /> .4 -IR11 P311p, In I I P,11111111 III mill 1 11 1 11-111 1-1 p upp-11 11 1 11, W <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,aftflce of Commencement Is required. (AIC upgrades over$7500) <br /> Agent(for the contradtor),or'PoWer of Attorney-(for the owner)would be someone with notarized letter from owner authorizing same <br /> DYER 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-pn public roadwayse n eds ROW <br />