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811 3-78MO20 City of Zephyrhills Permit Application Fax-8113-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin mte Owner Ph ne Number <br /> Owner N.fm <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS - -Z LOT# <br /> ARCEL ID#1 15� 026 101/6041:��1041410 441091e_� <br /> SUBDIVISION P <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONLSTR SIGN DEMOLISH <br /> INSTALL �ADD/ALT <br /> REPAIR <br /> PROPOSED USE = SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION = BLOCK 0 FRAME Q STEEL <br /> DESCRIPT.ON OF WORK 1&is'- / <br /> ' , <br /> BUILDING SIZE SQ FOOTAGE= HEIGHT <br /> TI'll �I <br /> VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL Is AMP SERVICE PROGRESS ENERGY 0 W.R,E.C. <br /> =FLUMBING is <br /> EOVECHANICAL IS g4r VALUATION OF MECHANICAL INSTALLATION <br /> ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> .64-64.& 1-11- <br /> BUILDER COMPANY <br /> SIGNATUR,z. REGISTERED I Yl N FEE CURREN <br /> Address License#r <br /> LECTRICiAN COMPANY = <br /> SIGNATURE REGISTERED I Y/ N FEE CURRE?, <br /> Address License# <br /> PLUMBER COMPANY 1 <br /> SIGNATURE REGISTERED I Y/ N FEE CURREK LXLN_J <br /> Addrcz;s 7 Llcehse#F <br /> MECHANIC AL COMPANY <br /> UF_ <br /> SIGNATUF_ REGISTERED I Y1 N FEE CURREN I YIN I <br /> Address Z�19149 1 <br /> WAS License# 16q&qL <br /> OTHER COMPANY = I <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN <br /> Addre is License#F7 <br /> RESIDENT:AL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction. <br /> Minimum ton(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 subdivisions/large projects <br /> COMMERCIAL Attach(2)oomplete,sets of Building Plans plus a Ufa safety Page;(1)set of Energy Fann5.R-O-W Permit for now construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stonnwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all now projects.All commercial requirements must meet compliance <br /> SIGN PERIVIIT Attach(2)sets of Engineered Plans, <br /> —PROPERTY SURVEY required for ail NEW construction. <br /> ."4 Directions:j ii a <br /> Fill ou application completely. <br /> Ownet&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AtC upgrades over$7500) <br /> Agent(far thd*cohtiactorY,o.r Power of Attorney(for the Owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (-PY of contract required) <br /> Reroch5 its ningles Seivvars: sarvic.a <br /> ypbrddes•A/C Fences(Plot/Survey/Footage) <br /> Drivew-ayr-Not over Counter if on public roadways-needs ROW <br />