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813-780-0020 City of Zephyrhills Permit Application Fax 81 3-780-0021 <br /> Building Department <br /> Date Recelv?d q I aD]q Phone Contact for Permitting--., <br /> Owner's Name eS Ow I nor Phone Plumber <br /> Owner Phone Number Owner's Address CQ cS�) <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Mia)[d,U) -�UIDJQ DY - LOT 9 <br /> SUBDIVISION ',/I V e PARCEL 100 Ot 00 - QMQQ 0 51 U <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDIALT- SIGN Q Q DEMOLISH <br /> - R INSTALL REPAIR <br /> PROPOSED:USE SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME STEEL <br /> DESCRIPTION OF WORK (M 10115+6 1 <br /> BUILDING SIZE F_ SO FOOTAGE HEIGHT <br /> 4444 <br /> =BUILDING VALUATION'OF TOTAL CONSTkOCTION <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> FVIPLUMBING <br /> 1$ HOD- OD I. <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS 0 ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ YES NO <br /> ............ HHUH ................. HI HI...H. <br /> BUILDER COMPANY I I <br /> SIGNATURE REGISTERED FEE CURREN <br /> Address License# F— <br /> ELECTRICIAN COMPANY I' - <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# r <br /> PLUMBER COMPANY 1-He'videoc)w <br /> SIGNATURE REGISTERED Y N FEE CURREN L4 <br /> _)L N <br /> Address c P p 0+h ff_)h to M P)d. License AMS og a3a I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED L.Y NJ • FEE qURREN <br /> Address Ucensd# F77- <br /> OTHER ,COMPANY <br /> SIGNATURE REGISTERED FEE CURREN <br /> Address License# <br /> R11.0...................... <br /> 18412'al"IHIN N 6 M a 2 i i i <br /> RESIDENTIAL-- -Attach(2),PlofPlans,:(2)sets of Buildthg*.Plainsf(I)Set ofEnerWForms;R-O-W Permit for new construction, <br /> Minimum tep-(-I%working days after subrfilttal date.:Required onStle.-CohsiructkinPlans'i Stonnwater Plans w/Slit Fence installed, <br /> Sanitary Facilitles-&1.duMpster,,Sltq Work Permit for subdivislonsfiargeprojects <br /> COMMERCIAL Attach(3)complete sets of Building Plains: plus a Ufa 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/Slit 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 /> 111151511-Bill 5111111111 <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 IC 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 /> Rerools If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Nat over Counter if-on public roodways-needs ROW" <br />