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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received _ �S C7 <br /> Phone Contact for Permitting Q <br /> Owner's Name a r,140A &lXe I Owner Phone Numbel <br /> Owner's Address 3-7-72 4/ S l'. Owner Phone Numbel <br /> Fee Simple Titleholder Name Owner Phone Numbe <br /> Fee Simple Titleholder Address F_ <br /> JOB ADDRESS 37i�1 j,53 r, ;J1JFt LOT# <br /> SUBDIVISION PARCEL ID# all 4 619 oo — bone <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT = SIGN = = DEMOLISH <br /> R INSTALL e REPAIR <br /> PROPOSED USE = SFR = COMM OTHER <br /> TYPE OF CONSTRUCTION = BLOCK <br /> = FRAME = STEEL = <br /> DESCRIPTION OF WORK •1 ile(DoC <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ . 1r7 <br /> �R <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION V <br /> =GAS ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> ■ ■ <br /> . I. <br /> - - - - - - - - - - - - <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N_J FEE CURREN LY/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE` REGISTERED Y/ N FEE URREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address I License <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE IURREN Y/N <br /> Address License <br /> OTHER COMPANY ,12ehl &1 �tt'Aeervj <br /> SIGNATURE REGISTERED JtV N FEE CURREN Y <br /> Address a-&SG Ce if License#1 6 C -7 !JS <br /> 1111111111111111111111111 111111111111111111111111111111111111111111 <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. Required onsite,Construction Plans,Stormwater 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.RI 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&1 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 /> 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$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(PlottSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />