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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received1nnnMMrrTTrrM I J.,Phone Conte pt for Permitting - <br /> Owner's Name gl1R> v r'- o 5�� '' Owner Phone Number �sbtu �d dl <br /> Owner's Address czac> d Owner Phone Number <br /> Fee Simple Titleholder Name. Owner.Phone Number <br /> �ry <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��� 4 LOT# <br /> SUBDIVISION PARCEL 0 D/o 00- d O`T o <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW.CONSTR ADD/ALT, 0 SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE Q . SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME STEEL Q ° <br /> DESCRIPTION OF WORK � � <br /> BUILDING SIZE SQ FOOTAGE= HEIGHT] <br /> "BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> r�_700 <br /> =ELECTRICAL 1$ AMP.SERVICE Q PROGRESS ENERGY t %}0 W.R.E.C. <br /> =PLUMBING <br /> [MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION r <br /> =GAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> f, <br /> BUILDER O PANY <br /> SIGNATURE •REGISTERED Y/ N FEE CURREA Y[N <br /> Address License# � <br /> ELECTRICIAN. COMPANY <br /> SIGNATURE` REGISTERED. Y/ N FEE CURREN, Y/'N <br /> Address - License# i <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y'/ N FEE CURREN LXLN. <br /> Address License,# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED YX'N FEE CURREN LILN <br /> Address License# <br /> OTHER COMPANY, <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN <br /> Address License# F <br /> RESIDENTIAL Attach(2)Plot:Plans;,(2)seu of Buiidfng:Plans;,(1)set;of Energy.Forms;;R-O-W-Permlt for new.construction, <br /> Minimum ten(10)working days*after subnlitWFdate. Required;onsite,Constriction Plans,Stormwa(er Plans w/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)mbrkin9 days after'submittal date:,`Reguired.onsite,Coristruction•Plans;_Stormwatbr:Plans.w/Silt Fence installed, <br /> Sanitary..Faclirldes&�1=dumpster.Site Work Permit for all new projects.All,commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)setsof Engineered.Plans: <br /> ""PROPERTY SURVEY required for all NEW-construction. <br /> 'Directions: <br /> Fill out application completely. <br /> Ownert 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 (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Pict/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />