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843-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone-Contact for Permitting- <br /> Owner Phone =m <br /> Owner's Name ....... `7 Nu­ <br /> Owner's AddressHOD ffl eref 5 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS I 2fl"56f) UaQl( A_j I CMSE y_.. LOT# <br /> SUBDIVISION e PARCEL ID#I aq-a D DD -0= - 0a;_�-)1D1 I <br /> n <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED NEW'CONSTR-M- ADDIALT' SIGN- DEMOLISH <br /> INSTALL F__j REPAIR <br /> PROPOSED-,USE 0 SFR F-1 Comm t 1 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK - E:] FRAME -STEEL <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ FODTAGEJ� <br /> HEIGHT [ � <br /> ' <br /> .......... 94.1114-1111111 1 1,11,13 44444444444444 <br /> [BUILDING VALUATION-Ofi-TOTAL CONStkOCTION <br /> =ELECTRICAL 1$ AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C. <br /> PLUMBING- <br /> 1$Iq 00 <br /> [MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> [ GAS ROOFING SPECIALTY. =, OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ®YES NO <br /> BUILDER COMPANY I I <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N j FEE CURREN <br /> Addres's License# <br /> PLUMBER . COMPANY <br /> SIGNATURE <br /> , REGISTERED YL N. FEE CURREN - WIN <br /> Address H bi TF-Fe"_ lew1g) W9- 1 License# I U5!5- 09R31di <br /> MECHANICAL COMPANY <br /> . _7 <br /> SIGNATURE, REGISTERED .1. YJ N FEE qURREh- <br /> Address License it F7 <br /> OTHER <br /> SIGNATURE 'REGISTERED I- Y/ M-4 FEE CURREN Y/N I <br /> License. <br /> Address #.[ <br /> i+H+H+H+ttf+ <br /> RESIDENTIAL,:-. -Attach(2),Pl6t,,Pla-n's-,',(2)sets 6f-6611d[6 6nhs;_W, for new construction, <br /> MinImUm49pt(j_9)wqrk Requirid o4ltd.,con-a waldr"016ris w/Silt Fence Installed, <br /> Sanit-ary Fact <br /> COMMtRCIAL Attach(3)coniii1bleFsets dif Building 01ah-S pu'Warts Permit for subdivisionsfi q a gqprojects__._,. <br /> plus S a Life Safety.Page-,(1)set of Enirgy* R-O Forms. -W Permit for new construction. <br /> ' <br /> Minimum ten(10)working days after submittal date.I Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.1 All commercial requirements.must meet compliance <br /> SIGN PERMIT Attach(2)-sets of Enjo6eirid'Plans. <br /> `*PROPERTY SURVEYpeqqiNd for all NEW construction.. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Modes of Commencement Is required. (AIC 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 roaiways-naeds ROW <br />