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813-780-MO City of Zophyrhills Permit Application Fax-813-78MO21 <br /> Btftng Department <br /> Received <br /> Data P Phone Contact for PennNng <br /> / I a 5 <br /> Owner's s Na FF—zeMW I - - - - -RAJ owner Phone Number ITS -7/Y--VA <br /> Owner's Address c.—ph.-Number F-- <br /> Fee Simple Tftholder Name Owner Phone Number F-- <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS1 -7,16' J LOT# <br /> SUBDIVISION 1041.0 PARCELIDII 76 <br /> 1 U (05TAIIIIED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEWOONSMN/ ADDIALT SIGN DEMOLISH <br /> R INSTALL REPAIR <br /> PROPOSED USE SFR = COMM OTHER r <br /> TYPE OF CONSTRUCTION r7 BLOCK FRAME STEEL M r- <br /> DESCRIPT.'ON OF WORK )v1e"&e1-U0-1eheAqe-4;'1 -) <br /> U V <br /> BUILDING SIZE SO FOOrAGE1 HEIGHT <br /> .1:!±fBUILDING;. . . . . .1$ . . . . . . . . .VALUATION.OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AM SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> =rwmBING is <br /> MMECHANICAL 1$,5-1P'7A VALUATION OF MECHANICAL INSTALLATION <br /> M CvkS 0 ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . . . . . . . . . . . . <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CUFLREK <br /> . Address I License# <br /> ELECTRICIAN COMPANY = <br /> SIGNATURE 1 REGISTERED I YIN FEE CURREN YIN <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREK LY/N <br /> Address Ucense# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREI, LXLN_J <br /> Address 174T/ filleAl kcl- License#Fd—&—o g-344 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURREIN LILN J <br /> Address License#F- <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans,(1)set of Energy Forms,R-O-W Permit for new construction, <br /> Minimum ten(10)worWng days after Submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sift Fence installed, <br /> Sanitary FEWIfifies&I dumpster,Site Work Pernut for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Ufa Safety Page-,(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)wod(M days after submittal date.Required orsite,Construction Plans,Stocrawater Plans wl Sflt Fence installed, <br /> Sanitary Facilifies&1 dumpster.Site Work Permit for all now,projects-AD 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 /> I "n.': <br /> I a It 1 , ft o 2 <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> hover$2SOO;a Notice of-Cow (AIC upgrades over$75M) <br /> Agent(for the,contr-'W)or Power of Aft—Y(for ft owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (COPY of ooe tract required) <br /> Rerooftifstitingles , sawmars Somee Upgrades AIC Fences(Plot(Surveyffioctage) <br /> Driveways-Nat over Counter if on public roadways-needs Row <br />