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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received -1 -:71—phoneZontact for Permittino. n <br /> 4__1 , I .-A- - <br /> r= <br /> Ownees Name Owner Phone Number <br /> Ownees Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS =beln 1 C 'Palm WaQ LOT a <br /> SUBDIVISION I l PARCEL lool'05-aU -91-mao- 00CL)00- oa-7ol <br /> I (OBTAINED FROM PROPERTY-TAX NOTICE1 <br /> WORK PROPOSED NEW CONSTR ADDIALT- SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSEDMSE SFR F-1 COMM OTHER <br /> TYPE OF CONSTRUCTION 0BLOCK Q FRAME STEEL _J <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE -ISO FOOTAGE 1 1. HEIGHT <br /> =BUILDING $ VALUATION 00 TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> PLUMBING I' DO <br /> =MECHANICAL <br /> rVALUATION OF MECHANICAL INSTALLATION <br /> I.. <br /> =GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> ............... <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LnN J <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED YIN FEECURREN LiLmli <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED N. I. fEEcURREN . IWIN <br /> Y <br /> Address M 511 )OC, -License"#fy) �enem V - 1 11 1 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED J .Y/ N FEE CURREN <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I' Y/ N_ I FEE CURREN ',L_YLN J <br /> Address License#-= <br /> RESIDENTIAL Attach(2),Plof.Plans;(2)Sets Of BIlldhig.Plahs-1(1)set of Enirgy:Forirns;R-P­W Permit for new construction, <br /> Minimum ten' (-10)wqrkIng;days afterstibmittal date.;Required onsIta.Construction Plans,Stormwater-plains w/Silt Fence Installed, <br /> Sanitary Facilities&.1 4umpster,Site Work Permlt for subdivislonsfiarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Oldn's' plus a Life Safety Page;(1)set of Energy Forms.R-OW Permit for now construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt 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 /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2300,a Notice 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 roadways..needs ROW <br />