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813-780-OD20 City of Zephyrhills Permit Application Fax 813-78MG21 <br /> Building Department <br /> Date Received <br /> Phone Contact for PermittinZ <br /> Owner's Name Owner Phone Number <br /> Owners Address 1. Owner Phone Number <br /> Loci LO <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS U 0-1 Q219:bM CY)(A& �)Y- - LOT a <br /> SUBDIVISION den Wly liV PARCEL IDN U- (91-0100 DQMD Dt 10 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDIALT- SIGN- DEMOLISH - <br /> R INSTALL 8 REPAIR <br /> PROPOSED.USE Q SFR F-1 Comm OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE F_ _] SQ FOOTAGE HEIGHT <br /> 44444-R4 14 1;A-4-11 W444444 <br /> =BUILDING $ VALUATION'OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY Q W.R.E.C. <br /> PLUMBING- <br /> 1$ 1- <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> ®GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ]YES NO <br /> ............... ......... ...............f+H+14+ H+t+H+H+ <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRM Y IN I <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEEcuRREh - <br /> Address License# <br /> PLUMBER P. e�teil .�Dy) <br /> SIGNATURE <br /> REGISTERED Y/_N FEEcuRRFh /N <br /> Address Abe_+�) I&em Y)d I License#*[QM_ nqla'3(A <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED YIN FEECURREN 7= <br /> Address License F_ <br /> OTHER COiWPAtY <br /> SIGNATURE REGISTERED N__ FEE CURREN <br /> Address License 4. <br /> RESIDENTIAL -Attach(2),Plot,Plans,(2)Sets of Building Plans;(1)set o.fE nargy-Forms;R-O-W Permit, for now construction,. <br /> Minimum.ten(.19)working days after submittal date. Required onsIt0.'CohstiucUon:PI a*n%Stormwater'Ola'tis w/Silt Fence Installed, <br /> Sanitary Facilities&.1.dumps1#r,,-SItqWo&Permit for subdivisiof,nsfiarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-OW Permit for now 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)sets of Engineered Plans.. - . <br /> """'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> N over$2500,a Notice of Commencement Is required. (AfC upgrades over$7500) <br /> Agent(for the Contractor)or Power of AttomAy(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING ..(Front of Application Only) <br /> Rerools If shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> Driveways-Not over Counter ifon public roadways..riis&ROW <br />