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City ofZephyrhillsl5erm' it Application Fax-813-780-0021 <br /> Building Department <br /> Date Received ai(v_O& CAV-kort,501 com <br /> Phone Contact for Permitting <br /> Owner's Name rx- Owner Phone Number ct <br /> Owner's Address ll-?-(,2oi-�: erom'pv- Owner Phone Number <br /> -Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address F_ <br /> JOB ADDRESS LOT# <br /> SUBDIVISION u e__ AC) PARCEL lDe Z 2S7 CSC 4 C) (A3bb <br /> (OBtAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONsTR F7 ADD/ALT SIGN DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR 0 COMM OTHER' 1 7777777 <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME STEEL <br /> DESCRIPTION OF WORK Yv �1pPlit fdAiihj reSOMLL Ipeel 1—_LQfil <br /> BUILDING SIZE SQJFOOTAGEE!!�r+_ HEIGHT <br /> =BUILDING ri,. . . ... . . . . . . . . . . . . . . <br /> VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING <br /> 1$ (0 <br /> =MECHANICAL Is VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER 01 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED FEft GURREi <br /> Address 12(OP2, me won, Zr License# ESE scm� 2 1 <br /> ELECTRICIAN o, > COMPANY Elerfi-i c <br /> REGISTERED �Y/ N FEE CORREN L <br /> SIGNATURE N <br /> Address 131 S. Ph U 'I License#'[EE 0 03-4- <br /> Uk fly (a <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N 'FEE CL1_RRtt\ L±LN_J <br /> Address A 7kv M-13 'TQW0q 10617—_7 License# <br /> MECHANICAL COMPANY Air <br /> SIGNATURE E REGISTERED FEECURREI\ '�'Y/N <br /> Address S 7' � Ct We 31�S—) License# <br /> OTHE COMPANY <br /> Li <br /> SIGNATURE REGISTERED Y/ N I FEECURREI\ Y/N 1,J <br /> Address 13143 V klkj 0,6 L 6w 3 � License# 1 uc :'13 252 3 3 <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)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 Plan's w/Silt Fence installed, <br /> Sanitary Facilities&1 dumoster.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 /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <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 Attorney(for the owner)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 />