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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received.. 0 Phone Contact for Permitting F dg/f <br /> .......... .......... rrrT7"rrm 1 1.............I.......--- ....... <br /> Owner's Name nn /4rA Owner Phone Number <br /> Owner's Address 0,60 We Pol-li dr Owner Phone Number <br /> CAJ- T <br /> loc X7 61 Owner Phone Number <br /> r <br /> JOB ADDRESS pI 0 LOT# C� <br /> SUBDIVISION PARCELID#1 I/- o4 - ol/--,00/0 - oelf <br /> 0,9- 'Ono <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR R ADD/ALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE Q SFR Q Comm EZ( OTHER <br /> TYPE OF CONSTRUCTION , BLOCK& <br /> 1,60T] FRAME STEEL <br /> �ervlee r /00 <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE [— I SCI FOOTAGE HEIGHT <br /> 11111111144 1.4 <br /> =BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION <br /> LECTRICAL 1$ <br /> d 000. 00 1 AMP SERVICE 1100 EZ" DUKE ENERGY Q W.R.E.C. <br /> '=PLUMBING 1$ <br /> =MECHANICAL <br /> 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING 0 SPECIALTY OTHER <br /> I <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN L)L/N <br /> Address License# I <br /> ELECTRICIAN COMPANY Ah o. 61"eck"e- -e /041 <br /> SIGNATURE REGISTERED Ity N FEE CURREN LO—LN—i <br /> Address License# Fr000/.;t 6 r <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Ly LN_J <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# I <br /> H!HHH H III!!I!HH HHH I!H HH if Hill!HHHHH HHHH HHH!I I I HHf I I I I I I I I I I f <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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/Silt Fence installed, <br /> Sanitary.Facilities' ' &I dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach'(2)'6omple'te sets of Building Plah§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/Silt 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�ql[NEW construction'.., <br /> U11111111 <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back ofo 0jJqQfi`n"nAanz9d1 <br /> If over$2500,a Notice of Conyrt -,c led. (A/C over$7500) <br /> ,!n �tjqeq ec.. <br /> Agent(for the contractor)or PoVjer-bfYAtto6my,,Jor tMe-'p-me r)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required.) <br /> Reroofs;if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />