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city of Z_ephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting I <br /> I I I I I I I V-F I I <br /> -- <br /> Owner's Name C_ Owner Phone Number <br /> --Owner Phone Number <br /> Owner'sAddressl _1437 <br /> Fee Simple Titleholder Name F \;_axs Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION EL ID# 7-1;;7 Z 1 6 1 q0 00C, <br /> (OBTAINED FROM PROPS RTYTAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT U SIGN DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION E:2— BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK ' IQ Zo Je '&J 7- Saffi <br /> J <br /> BUILDING SIZE S' Q FOOTAGE '1406 -eHEIGHT <br /> . . . . <br /> =BUILDING M7 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> ]GAS ROOFING' SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> . . . . . . . . . . . <br /> BUILDER COMPANY nc <br /> SIGNATURE ff� REGISTERED FEE CURREN Y/N <br /> Address b2(1)D2 Te)ff=_br_ -7414-A License# 1 CZ16,039C422 <br /> ELECTRICIAN COMPANY -�4mrlo Plec4i4,Ir <br /> SIGNATURE REGISTERED N_ ' FEE CURREN /N <br /> Address 54-1%VS_ &AN aw" 3 License# <br /> PLUMBER COMPANY St�: R I(J tfl <br /> SIGNATURE J REGISTERED Y/ N 'FEE IOURREN N <br /> Address (ISID H01616h RW 4S_klom �wi 3 License# <br /> MECHANICAL COMPANY oit� '\P <br /> S�Isl— , � <br /> SIGNATURE -,.......... REGISTERED YI*N FEE CURREN\J <br /> Address 4- LhL�A Qt6m --wm License# Z�Z_(,33 9 <br /> I <br /> OTHER COMPANY ly-(tck H_CNA-,1c1 <br /> SIGNATURE " REGISTERED Y1 N I FEE CURREN Y/N <br /> Address 3 tp License# I CC- <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 Slit 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 F6iM___S*'.R-O-WPenTilt for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans W/Silt Fenceinstalled, <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 ail NEW construction. <br /> V 1 2 a <br /> Directions- 464 <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 qwKer­authbr1z1n9.Sam1� - <br /> OVER THE COUNTER PERMITTING <br /> (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 />