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1813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received zz— 9 Phone Contact for Permitting <br /> ............. .......T"rT= raXM3M33= <br /> Owner's Name Owner Phone Number <br /> --.,&- S 1 �,1,7 <br /> Owner's Address 337 6' de,r-I, Z Owner Phone Number <br /> Owner Phone Number <br /> JOB ADDRESS S LOT# <br /> SUBDIVISION Pil iy I-e- PARCEL ID'# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN Q 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK //0 J,5 <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> mmg;HH!4� 1killillh <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE 0 DUKE ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> Ile <br /> /V <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION pto-i-, <br /> =GAS Q ROOFING Q SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> r- )Pu <br /> BUILDER -,t(COMPANY-� <br /> SIGNATURE REGISTERED L Y/ N FEE CURREN L_yl N J <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N I' FEE CURREN L_yl N_J <br /> Address License# F <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# F_ I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LXLN J <br /> Address x/ License# F <br /> OTHER <br /> COMPANY <br /> SIGNATURE REGISTERED FEE CURREN Lyl N J <br /> Address License# F <br /> ........... <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permif for new 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 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 Plans w/Silt Fence installed, <br /> Sanitary Facilities,&1 dumpster.Site Work Permit for all new projects.All commercial requirements rust meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> ............... <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.- (AJC 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+ (COP act'*itIqired)Or CC <br /> Reroofs if shingles Sewers -A/ urvey/Fo6tage) <br /> __,�e U - 0`,% Fences(Plot/S Ogt�det , <br /> p'Ubli'd'�roadW5y�.':rfeddi.,'ROW Driveways-Not over.Counte.eff on, <br />