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813-780-0020 City of Zephyrhills Permit Application r-ax-O-1,5-f ov-VV4 1 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permitting <br /> Owner's Name �J'a 5,5 12 Owner Phone Number i 3 - (�o <br /> A - k\—JGLC4P1'e-4'_ .1 <br /> Owner's AddressF-5(e,5 c;f Owner Phone Number <br /> Ze K 2- Owner Phone Number <br /> 4?, <br /> JOB ADDRESS LOT# fZ <br /> r 0 <br /> ­6 -1 6 :31 (00 -00 <br /> SUBDIVISION 5 PARCEL <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE Q SFR 0 COMM OTHER g\ CIL <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME STEEL <br /> DESCRIPTION OF WORK <br /> UZ—YSyt Y <br /> BUILDING SIZE SCI FOOTAGE= HEIGHT �v <br /> ...........A <br /> F71BUILDING $ VALUATION OF TOTAL CONSTRUCTION ! <br /> =ELECTRICAL 1$ AMP SERVICE 0 DUKE ENERGY W.R.E.C. <br /> =PLUMBING 1$ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> .. ........... .......... <br /> ... ...Z7 BUILDERe'� COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN /N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN L=N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN L_y <br /> L N <br /> Address License# F_ <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> HH 1 H!HHH!H 1 <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)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 Set is-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 vil Silt 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 Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> PPA44444444444mim- ........ <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. (AIC upgrades over$7500) <br /> Agent(for the contractor)or F,6w6i:bi,,Atioehi b*y­(f-0-'r"i`K 6- 6-w'n e-r).-w6u­lld be someone with notarized jett%,frpm,owner authorizing same <br /> OVER THE COUNTER PERMITTING (qpp y19f,qpnt!pctfeqbired <br /> ewers U <br /> Reroofs it shingles S S es(Plot/Survey/Footage) <br /> Driveways-Not over Counter-if on.public roadways needs ROW <br />