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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 <br /> rrTrff .............. ........................... .................................... <br /> Owner's Name 4 71 Owner Phone Number <br /> Owner's Address 44 f, 22 V k Owner Phone Number <br /> Fee Simple Titleholder Name F Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 55 ai j ryr c o/Vi 41- LOT# <br /> SUBDIVISION E i s o ill ij"CA PARCEL ID# -proT <br /> 0 (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK,PROPOSED NEW CONITRR ADD/ALT Uz� SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE EV SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME STEEL <br /> DESCRIPTION OF WORK fle,,VfpcG"Wi f tV41T1 -.141CITfir Afrl��11_ <br /> ; I <br /> BUILDING SIZE <br /> SQ FOOTAGE HEIGHT 'M' <br /> ........ ..........------------ <br /> EnBUILDING VALUATION OF TOTAL CONSTRU <br /> 6000. 070 VALU CTI1 <br /> LELECTRICAL $ AMP SERVICE = PROGRESS ENERGY Q W.R.E. <br /> =PLUMBING 1$ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY 0 OTHER <br /> � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YE8` oN .% <br /> BUILDER COMPANY <br /> SIGNATURE eov 'REGISTERED Y/ N % URREN ; <br /> Address License4f , <br /> ELECTRICIAN COMPANY <br /> SIGNATURk REGISTERED Y[W LYLN J <br /> L F <br /> Address icense <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y N• J" FEE CURREN L_)2-N J <br /> Address <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y,-/ N­ FEE'cuRREN <br /> Address License#. <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N_- FEE CURREN N <br /> Address License# <br /> RESIDENTIAL Attach Plot Plans;(2),set&of-Building Plans;(1),set,of.Ener'gy Forms;R-O-W,-Permlt for new construction <br /> Minimum ten(10)working,days"Aftersubmittal date. Riiqu.ired onsite.Construction Plans,Stormwater Plans w/Silt Fence installed. <br /> Sanitary Facilities&I dumpster,Site Work Permit for subdivisionstiarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life,Safet,y 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 dumpsIer.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 req <br /> uired for all NEW construction. <br /> 'Direction111111111111444-1gas Iraq all 14-pp Iffills—PP14:1444;.........giBiffrila....... <br /> - -----------r------------­--------- --- .............. <br /> a: <br /> Fill out application completely. <br /> Owner&Contractor sign,bac'k 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 /> j - ' -Upg\R�er Sewers oofs if shingles SerVic r er !ad6s-A/C Fences(PlottSurvey/Footage <br /> Drlveways=Not over Counter if on public <br /> rdadwOys:needs ROW <br />