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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received '101 q Phone Contact for Permittl qD1 <br /> .......... rrc= <br /> Owner's Name I Law LIS Owner Phone Number <br /> Owner's Address; tocol.4 N P ress Sf, I Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 95sa LOT# <br /> SUBDIVISION PARCEL ID9 I —Q i I Q 00SDO 0050 <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR R ADDIALT* SIGN- DEMOLISH -INSTALL R REPAIR <br /> PROPOSED.-USE SFR 0 COMM OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK FRAME STEEL <br /> ci �i w " <br /> DESCRIPTION OF WORK a- M <br /> BUILDING SIZE SO FOOTAGE HEIGHT <br /> 11011111114 1 1 1 1 1 1 1 11 1144444444 1, 111 1 1 1 <br /> "BUILDING, 1$ VALUATION"OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE, Q PROGRESS ENERGY 0 W.R.E.C. <br /> PLUMBING $1 --�L��,� -� <br /> =MECHANICAL 1$ j VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> HHHH!............ HHHHHi HHHH!H 1 Ill 1 H4+H4+ <br /> BUILDER COMPANY I <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address I License# <br /> ICiAN COMPANY <br /> SIGNATURE REGISTERED Y/ FEECURREN -LILN <br /> ELECTR <br /> j <br /> Address License# I <br /> PLUMBER COMPANY flfnd= IVY a+1 <br /> SIGNATUREt'� REGISTERED I Y/ N. FEE CURREN Y/N <br /> Address 1451) ft-Ailehem Ucense#' �o <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y.1 N FEE CURREN Y l N_j <br /> Address License# <br /> OTHER � .,. -.COMPMY­t <br /> SIGNATURE REGISTERED J' Y/ N_ FEE CURREN L_jLN J <br /> Ad-dress r :_7 License'#. <br /> 4+"+H+ HHHHHHHHHAHHHH#HHHHS I.!I A,I I HHHOHHHHHHAR! <br /> RESIDENTIAL Attach.(2),,:Plof Plans-(2)sats.of 96ildining!PI ains;(1)set of-EnergyForma-'R.O.W' Permit for new construction, <br /> MinimurnAept(10)working',days ifter.su-bInittal date.:Required ons'lt6,--Consiruct1on-Plans-�Stormwater'Plans w/Slit Fence Installed, <br /> Sanitary FacliIII es''4:1.4urripstpr,$Ite-W. ork;Perm1t for subdlyislonsfiarge 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 new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence Installed, <br /> Sanitary Facilities&1 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$2500,a Notice of Commencement Is required. (A/C upgrades over$7500) <br /> Agent(for the 6ontractor)'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 AIC Fences(Plot(Survey/Footage) <br /> Driveways-Not over Counter Ifjon public roadwbys..n6edii ROW <br />