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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-002i <br /> Building Department <br /> Date Received Cq <br /> .......Ir Contact for Permitting <br /> Owner's Name Owner Phone Plumber <br /> Owner's Address ig(200 wppe7,53 st, Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS [5003 mmiden AcAlow Ov. LOT <br /> C <br /> SUBDIVISION en ?�t Vf,!( PARCEL IDO U"off 1 0100 00000 05RO <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 CONSTRUC710H Q BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK (Y) 'If f)AtA t <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> .......... Ali <br /> =BUILDING, VALUATION OF TOTAL CONSTRUCTION I <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> PLUMBING <br /> rj!60. <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> ®GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> ..................... ......... .......... <br /> +H+H+H4+H+f+ <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED L)LL N J FEE CURRF <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURREN <br /> Address License# <br /> PLUMBER COMPANY Mf_nckv�n <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN Ly N J <br /> Address F4 5 1 leArle-M 7 Licen so.# FG55— Cq a 3 a <br /> MECHANICAL COMPANY <br /> SIGNATURE F REGISTERED L__Y N FEECURM:J <br /> Address License# F <br /> OTHER 'COMPANY <br /> SIGNATURE REGISTERED I- Y/ N, FEE CURREN Y/N <br /> Address License 4- <br /> ................................................I .............. <br /> s rgy nn' <br /> RESIDENTIAL -Attach(2)Plot.Plans;(2)Sets of BU+IIdln§-PIans_;(1)''et oIEne __'Foi; s,R-P=W Permit for new construction, <br /> Minimum ten-(jq)working idaysaftersubmittal date.:Required onsita,'Co-iistimlion Plans,Stoffnwater'014fts w/Silt Fence Installed, <br /> Sanitary F4p'lilUes,&.I.duMpster,,-Site Work.,,Permit for subdivisloPs.11arge projects <br /> COMMERCIAL Attach(3)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 Plans w/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 Efigine6pod Plans. <br /> `*PROPERTY SURVEY required for all NEW construction. <br /> gi ".4 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. (AfC 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 .-(Front of Application Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter iff-on public roadways-needs ROW <br />