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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 q <br /> C?) 1,11 aDa I I III is 2177E� M 1 7 <br /> Owner's Name Lcmoy- +1 o ffl C S Owner Phone Number <br /> Owner's Addressl qWOD LO =I S4 Owner Phone Number <br /> Fee Simple Titleholder Name I Owner Phone Number <br /> Fee Simple Titleholder Address F <br /> JOB ADDRESS [11 a u N++on U Dyt LOT# <br /> SUBDIVISION PARCEL ID# Lp - 0 0= — <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRF7 ADD/ALT SIGN DEMOLISH <br /> e INSTALL = REPAIR <br /> PROPOSED USE Q SFR 0 COMM L.J OTHER <br /> TYPE OF CONSTRUCTION BLOCKO FRAME 0 STEEL <br /> DESCRIPTION.OF WORK 1 Y y (A+]Do i n<, )iQ 11 <br /> BUILDING SIZE SQ FOOTAGE= HEIGHT <br /> =BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION ti <br /> =ELECTRICAL 1$ AMP SERVICE 0 PROGRESS ENERGY 0 W.R.E.C. <br /> PLUMBING <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> nooffENERIKI . 1mmumosommusess owns . . . . REENNERE.. . . . . . . wooffisoffall.- <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address I License# F_ <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN L)LL N <br /> Address License# F_ <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN rY/N <br /> oe , I <br /> Address RITEA1 P License# 1 tns-�U'f)0� <br /> MECHANICAL COMPANY <br /> SIGNATURE F REGISTERED Y/ N _J FEE CURREN L_y/N <br /> Address License# <br /> OTHER COMPANY I <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <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 wl Silt Fence installed, <br /> Sanitary Facilities&1 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 Plans w/Silt Fence installed, <br /> Sanitary Facilities&I 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 /> . . . . . . . . . . . . . . . . . . . . . . <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 />