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813-780-0020 City of Zephyrhills Permit Application 10VP 'P') /1 Fax-813-780-0021 <br /> Building Department 7 <br /> Date Received Phone Contact for Permitting <br /> ........ .... .... ....... . .............. ......... <br /> 4 71 <br /> Owner's Name (,I 64��� Owner Phone Number 17 92 <br /> Owner's Addressl 3 !qn'-'- 10", C605-t Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS r-3 `51M %(.A1S01A CvIOS <br /> c LOT# <br /> SUBDIVISION I Ht JC41/1 et Cl) I PARCEL ID#124 --0//0—oo v c)d—00 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK-PROPOSED NEW CONSTRR ADDIALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK t/ U4, �e �116' A IT2 6 60 <br /> BUILDING SIZE I I SQZeOTAGE HEIGHT 1 6 'd <br /> ........L 41,11 <br /> =BUILDING q0 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL Is AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING 1$ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER c/,//- COMPANY 14op".,e <br /> -SIGNATURE REGISTERED Y/,N <br /> a#Address Lice.a. T Add <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N— F.EE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> ---SIGNATURE REGISTERED Y/ N FEE CURREN LXLNLJ <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y,t N FEE CURREN <br /> Address License#,F— <br /> OTHER COMPANY <br /> OTHER <br /> REGISTERED Y/ N. FEE CURREN <br /> Address License# F— <br /> I till 9 11 11 1 1 11 H'!11 1111 11 1 1 111 1 11 1-! 1,1 111111 <br /> RESIDENTIAL Attach'(2)Plot Plans;(2):setsof Building Plans;(1),set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working'days*after'submittal date. Required onsitia,"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:Safqty 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 wif 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 /> ---------- <br /> Fill out application completely. <br /> Owner&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_ _,_(cppy of contract required) <br /> Reroofs If shingles 5ewers Service;Upgrades an <br /> Driveways-Not over Counter if on pubIi6'ro-a­dw6yi..6 dikow'.-a"; <br />