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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-002i <br /> Building Department <br /> Date Received Phone Contact for Permitting ol 1511 <br /> 'I Owner Phone <br /> Owner's Name Number <br /> -1 1"CW <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS M95, LOT <br /> SUBDIVISION PARCELiD#1`a5 aW- 011- DI DO -ccWo- D530 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED e <br /> NEW CONSM ADD/ALT SIGN- 0DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED.USE Q SFR Q COMM- OTHER I <br /> TYPE OF CONSTRUCTION Q BLOCK 'E:] FRAME STEEL <br /> DESCRIPTION OF WORK. <br /> BUILDING SIZE 6(aFOOTAGE=. HEIGHT <br /> .......... <br /> ®BUILDING $ VALUATION,OF TOTAL CONSTRUCTION. I <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> 06PLUMBING 11 Mo .00 1, <br /> =MECHANICAL $ [ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> .......... ........ ............... H-I ............... <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED LKLN J FEE CURREN <br /> Address License# F <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED FEE CURREN <br /> Address I License# F <br /> PLUMBER COMPANY C ky "'n, wfion <br /> SIGNATURE REGISTERED Y/ N FEE cuRREN-- I WIN t <br /> Address fin hd License I UtO_ r\4a,32 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> i Address Uce nse#,F <br /> OTHER .COMPANY <br /> SIGNATURE REGISTERED YJ N_ FEE CURREN <br /> Address License# <br /> ............ <br /> RESIDENTIAL Attach'(2):P-16t Plans;,(2)sets of Bulldlhg�Plains;(1)idi of gnergyFoffimsi R-0-.W Permit for.now construction, <br /> Minimum,ten(10)working days aftersubmittal da!6.�Required onsito,&s6clion0lans..Stormwater"011an's w/Silt Fence Installed, <br /> Sanitary Facilities&.I.durnpster,,-Site;Work Permit for subdivislansnarge projects <br /> COMMERCIAL Attach(3)complete sets of Building 01a n*i plus a Life 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 wl 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 Engli*i6lired Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> . q <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. (A(C 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 if on public roadways..n6eds ROW <br />