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813-780-0020 city of Zephyrhills Permit Application Fat-813-78MO21 <br /> Building Department <br /> Date Received Phone Contact for PermittIN o <br /> IS ISSA& aq <br /> !Owners Home I" a O'wonorglilhonaNumb,or %vl NOXM *— <br /> Owners Address I aye owner Phone Number <br /> Fee Simple Titleholder Name owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESSI rtr LOT 9 <br /> SUBDIVISION PARCELIM I—(X—>(4D 00 IN-Cx')60 <br /> (OBTAINED FRONI PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRR ADD/ALT SIGN DEMOLISH <br /> R INSTALL REPAIR <br /> PROPOSED USE F-1 SFR E::] COMM OTHER <br /> TYPE OF CONSTRUCTION = BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK % Ile, Q-00Y INNN. ! -?mAixi Az <br /> BUILDING'SME is HEIGHT <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL is AMP SERVICE 0 PROGRESS ENERGY r--1 W.R.E.C. <br /> =PLUMBING 1$ <br /> =MECHMICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> BUILDER COMPANY I INMN 'R.XJ\e4rX I <br /> SIGNATURE REGISTERED I Y1 N r FEECURM L N J <br /> Address Wt u..# <br /> ELECTRICIAN COMPANY —N <br /> SIGNATURE I YIN FEE VJRREA L <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE I i REGISTERED I YIN FEE CURREN Y/N <br /> Address License# <br /> MECHANICAL COMPANY = <br /> SIGNATURE REGISTERED I Y/N FEE CURREN <br /> Address I UCense#F— <br /> OTHER COMPANY = <br /> SIGNATURE F REGISTERED I Y/ N I FEE CURREh <br /> Address F— license#r- <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)M 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 81 dumpater,Site Work Permit for subdiv[sionsfiargo projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for now Construction. <br /> Minimum ten(10)worldng days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for ail now project&All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)as%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 /> Kover$2600,a Notice of Commencement Is required. (AfC upgrades over$7600) <br /> Agent(for the confisider)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 /> Reroola if shingles Sewers Service Upgrades A/C Fences(Plot(Survey/Foolage) <br /> Driveways-Not over Counter If on public madways..neads ROW <br />