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811a80-00216 Cify•of ZephyrhillsPermit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting - <br /> Owner's Name ��/1 M 5 � ' Owner Phone Number <br /> Owner's Address GAY) Dhk 45 f !S-,14a Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ty� D r h' II L5 l 2 LOT# <br /> SUBDIVISION PARCEL ID#R IG 9-L 000-0 0030 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR ADD/ALT = SIGN = MOVE = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME Q 1/STEEL Q OTHER <br /> DESCRIPTION OF WORK E.0. �'�'1 r- AI Ki S L y i�i <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> = ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> = PLUMBING $ <br /> l <br /> = MECHANICAL $ Q�� VALUATION OF MECHANICAL INSTALLATION <br /> = GAS = ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address I License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address F License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N_ FEE CURRENT <br /> Address I V License# <br /> MECHANICAL — COMPANY uZ 1 l(7rv� o CA i <br /> SIGNATURE REGISTERED Y/ N FEE CORRENT Y/.N <br /> Address Wv 6,a< l3(t2 u_n kfrL A (d g License# CA 5 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address License# <br /> --RESIDENTIAL_ _ Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms <br /> Minimum ten(10)working days after submittal date.—Required-dnsite,Construction Plans;Sanitary Facilities-«i-dan pater <br /> COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster <br /> All commercial requirements must meet compliance. <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> Directions: <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$5000) <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 (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />