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813-780-0020 'N <br /> City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting ( 9\3 <br /> L.LL- ................. ........... rrrrm <br /> Owner's Name S-\L16-4-k- 1 "-P Owner Phone Number <br /> Owner's Address S 1 eAIN\0("� Owner Phone Number <br /> Owner Phone Number <br /> JOB ADDRESS O 5 V,f4vy^o LOT# <br /> SUBDIVISION PARCEL ID# oo5-6-000w- oc):�o <br /> (OBTAINEMFROMPROPERTY TAX NOTICE)' <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN' DEMOLISH <br /> e' INSTALL R REPAIR <br /> PROPOSED USE SFR COMM OTHER <br /> TYPE OF CONSTRUCTION' 0 BLOCK Q 'FRAME STEEL <br /> DESCRIPTION <br /> N OF WORK 'CO :Skr1&\e_S FL- 161 <br /> BUILDING SIZE ISQ FOOTAGE MEIGHT ,F. <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION. t 9� 100 .00 <br /> =ELECTRICAL 1$ AMP SERVICE Q DUKE ENERGY Q W.R.E.C. <br /> =PLUMBING <br /> 1 7- <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR,ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN . L_YLN_j <br /> Address, License# <br /> ELECTRICIAN- COMPANY <br /> SIGNATURE REGISTERED' Y-/;,N FEE CURREN Ly LN_J <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE ,REGISTERED Y P N FEE CURREN <br /> Address. License.# <br /> MECHANICAL COMPANY <br /> SIGNATURE- REGISTERED I Y/ N FEE CURREN <br /> Address License# <br /> OTHER COMPANY- <br /> 1 3 Lott <br /> SIGNATURE REGISTERED 'Y/ N,_ FEE CURREN - I. Y1,N, <br /> Address 1'1�0 o License <br /> L 1 <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. ,Ikeouired onsite,Cbnstirucu'ori Plans,Siormi+Bier Plans w%Silt Fence installed, <br /> Sanitary Facilities&1.dumpster,-'Site Work Permiffor s*U'b&14I6nsfiarg6-projects <br /> e� , <br /> COMMERCIAL Attach(2)complete.sets-of.Building Plans.plus,a.LlfSafety,Page;(1)set <br /> et"of.Energy Forms.-R-O-W Permit foriniw construction.- <br /> Minimum ten(10).working.days after submittal date. Required-onsit%Construction Plans,StormwaterPlans",w/S'ilt Fence Installed,' <br /> Sanitary,Facilities&I dumpstdr-.bitd Work Permit for ill new projects.A.11 commercial requirements, must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> .."PROPERTY SURVEY required for all NEW construction. <br /> 11 1 111111441111 a 1 1 1111-41111 111111111 W I <br /> Directions: <br /> .Fill out'application completely. <br /> Owner&Contractor sign back of,application,notarized <br /> 'If'over$2tOO,;iNot.icoof.'C,omyvienceiiiintisrequired. (A/C upgrades.over$7600) <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 (ropyof 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 />