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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 /> Owner's Name LIC'M CJY flumn___ Owner Phone Number <br /> Owner's Addressl�WCD Owner Phone Number <br /> Fee Simple Titleholder I Nams, _71 Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS [!PUA� DauDtm CVVS� Dy , LOT# <br /> PARCEL 0CM 51 SD SUBDIVISION CUM A ffy I ID#_ 3U- 01- DW <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTRR- ADDIALT' SIGN, DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED-,USE Q SFR Q Comm OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL CJ <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SO FOOTAGE= HEIGHT <br /> 11111444444 t I jj,j tiltll! <br /> =BUILDING $ VALUATIONiOF TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> PLUMBING <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> 111 1 H444+H++++ +H4+H+ <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN N <br /> Address I License# <br /> ELECTRICIAN COMPANY L_ <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LYLN J <br /> Address License# F <br /> PLUMBER COMPANY i 14CMCV( <br /> SIGNATURE REGISTERED Y/ N . FEE CURREN ',Y./N <br /> Address 1951) ?,)e+h1n)ffn I License# I L-5, 5 0-0-MM <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N . FEECURREII <br /> 7 Address License# F <br /> OTHER ..COMPANY SIGNATURE REGISTERED Y/ N__ FEE CURREN <br /> Address License# r <br /> 1tfff I+fi-i 111111111111111 11H. <br /> RESIDENTIAL.- Attach(2).Plot,Plans;.(2)sets.of Builldiing'.Pi ans;(1),iat of E nergy�Forms:R-O-W Permit for now construction,' <br /> minimum.tep-(10)wqrk(ng',days after:subtfilttal'date.;Required onsite,taihstruction.Plans-,.Stormwater Plans w/Slit Fence Installed, <br /> Sanitary Faicilllies.&.l duMpster:,+SIte-WorkzPennIt:for subdivisignsfiarge:pmjects <br /> COMMERCIAL Attach(3)-complete sets of Bu-Ildl riq Plans plus a Life Safety Page;(1)set of Energy.Forms.R-O-W Permit for new oonstructon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Slit Fence Installed, <br /> Sanitary Faidlities&1 dumpster.Site Work Permit for all now 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. (AIC upgrades over$7500) <br /> Agent(for the contractor)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 A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter If..on public roadways..need6 ROW <br />