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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> .......... ...............IXM;310xIXlXMXlx=........ <br /> Owner's Name 5C174 f,"7 P Z_ Owner Phone Number <br /> Owner Phone Number <br /> Owners Address 611L,77TI <br /> Owner Phone Number <br /> JOB ADDRESS r T- LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK-PROPOSED NEW CONSTRR ADD/ALT SIGN DEMOLISH <br /> e INSTALL iREPAIR <br /> PROPOSED USE SFR Q COMM OTHER <br /> TYPE.OF CONSTRUCTION Qp <br /> BLOCK Q FRAME STEEL <br /> DESCRIPTION.OF WORK /I alto cIrr5- <br /> _J <br /> BUILDING SIZE SQ FOOTAGE[ .....J HEIGHT. <br /> BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =IELECTRICAL 1$ AMP SERVICE DUKE ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE`AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LY-N <br /> Address I . - License# L__j <br /> 4;2 ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LLLN J <br /> Address 1 4 oo- 71n- License# F/-- <br /> PLUMBER COMPA NY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address Llcense#F_ <br /> MECHANICAL -COMPANY <br /> SIGNATURE -REGISTERED Y/ N' FEE CURREN LaN J <br /> Address F_ License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED LY/ N FEE CURREN LYIN J <br /> Address. License# F <br /> —RESIDENTIAL Attdch(2)Plot�Plan's;(2)sets.of Bulldlri PS_;- _g7 pla '(1)set 6f.Energy.'Forms;:R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Con'structibn Plahs,Stdrmwater Plans w/Silt Fence installed,' <br /> Sanitary Facilities&I dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets 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 da"ys'eifter subrhlftal'dbte.-Required onsite,Construction Plans,Stormwater Plans w/Silt Fen-ce installed, <br /> Sanitary Facilities&'1-clumppter.Site Work Permit forall 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 /> IIiII4441111121 is 1;1 11iIIIIIIII III g 1 3 111 11-I I I I I I I-— 111 1111.... <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. (A/C upgrades over$7500) <br /> Agent(for the contractor):or:,Power-of--Attotn-ek-,(for tti66,w_bt)-would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING, <br /> `'"Service U <br /> ences;(Plot/Survey/Footage)if shingles ".Sewers <br /> Driveways-Not over�b66iiie`1, on`public:ba ROW <br />