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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> Date Relfilve;i Phone-Contact for Pe I hig- <br /> 13: <br /> Owner's Name Owner Phone Number <br /> Owner's Address lqw) W CUM% S4 , Owner Phone Number, <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION PARCEL IDJOH RW -R1- D1Q -00q00- 00,50 <br /> (OBTAINED FROM PROPERTY.TAX NOTICE) <br /> WORK PROPOSED NEW CONsTRF-1. ADD/ALT SIGN, DEMOLISH - <br /> INSTALL REPAIR <br /> PROPOSEDMSE Q SFR comm- OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK. (AF!Qn ncc_-)!a I I <br /> BUILDING SIZE SQ FOOTAGE-= HEIGHT <br /> 11111444444 1481 ga I I a-.1 x I-A <br /> =BUILDING $ VALUATION'OF TOTAL CONSTRUCTION <br /> [ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> F-VIPLUMBING- <br /> 1$1500- 00 <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY OTHER, <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ®YES NO <br /> t .............................. <br /> HHHHHH, 1H H414 1111 HH 11111,1111111 Hill Hl 112 1111111 H4+H+f <br /> BUILDER COMPANY I <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address 7 License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE s REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> PLUMBER a�COMPANY NfYY1QL SIGNATURE REGISTERED Y-/.--N,- . -FEECURREN-- YY-/N -1 Address N15LI �6?_+hle_bm -WC4 11 License I USb Oq a 3 <br /> MECHANICAL COMPANY. <br /> SIGNATURE REGISTERE <br /> D YJ N FEE qURMN: <br /> Address:- License#-.F <br /> OTHER COMPANY <br /> 1* Y/ W-] FEE CURREN L�N- <br /> SIGNATURE REGISTERED <br /> Address License# <br /> ........................ ...........I.................................... <br /> RESIDENTIAL: iiergi�Foiini.,ii-o-W Permlifbr now construction, <br /> ',- Attach,(2)�I?16t,_Plains�,,.(2)iitS.6fBi6IldIh E" <br /> Minimum:*ten�(,Ip)wqrking,,d6ysafter,sdbrhlttaidatia.��'Rdquifedonsite, ftiiuctlohPlans,StormwateIr'Plans w/Slit Fence Installed, <br /> Sanitary FacllitleA&j..duMpstqr,,Site Work Permit for subdivigionsnargelprojects'-.-, <br /> COMMERCIAL Attach(3)-complete'sets of 6dildirig Pldnis 016s-a Life Safety Oa6a;­(I)set of Energy Forms.R-O-W 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 Engjh_ee're'_,d'-PI4'n_ .-s " <br /> *'PROPERTY SURVEY req <br /> uired for all NEW,00nstructlon. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Not1rce of Commencement is required. (AfC upgrades over$7500) <br /> Agent(for the conliabtor)orPoWer of Attomby(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(PlottSurvey/Footage) <br /> Driveways-Not over Counter Ton public roadways-heeds ROW <br />