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Fax-813-780-0021 <br /> t313-780-0020 � �"' City bf Zephyrhills Permit Application <br /> auilding'Depariment <br /> , Date Received -' Phone Contact for Permitting <br /> u j;t s <br /> Owner's Name �J to 45- Owner Phone Number <br /> Owner's Address _5'90 / f"�2� R�1 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address — <br /> JOB ADDRESS J /LUG LOT# <br /> SUBDIVISION r J✓VGL ©If& _ PARCEL ID# 0 3 —�J �� 1 `� '"' 104 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R <br /> NEW CONSTR e ADD/ALT = SIGN 0 = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM = .OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK 0 FRAME y�f STEEL <br /> .: Q <br /> DESCRIPTION OF WORK �i� U/y 7l <br /> BUILDING SIZE F 71 SQ FOOTAGE HEIGHT <br /> =BUILDING $ D VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE [� PROGRESS ENERGY Q W.R.E:C. <br /> =PLUMBING $ -71 . <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN, Y!N <br /> Address - License# L — <br /> ELECTRICIAN COMPANY <br /> SIGNATURE a REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED LILN_j FEE CURREN Y/N <br /> Address License# �— <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N j FEE CURREN Y/N <br /> Address License# <br /> OTHER C/� COMPANY ()-�-�V �Q�.' <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Ljj N <br /> Address fl lr rP �l l�t�TI License# I ZZ o 0 q W 2- <br /> Hi-Hiii <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.R-O-W Permit for new construction. <br /> 1. Minimum ten(10)working.days.after!submittai•'date..•Required onsite,Construction Plans,,Stormwater Plans w!Silt Fence installed, <br /> i Sanitary Facilities.&1•dumpster..Site Work Permit for all new:projects.All commercial requirements must meet compliance <br /> $ION PERMIT Attach(2)sets of Engineered Plans, <br /> i' ""PROPERTY SURVEY_ qe ulredfor all NEW::construction. <br /> ' Directions: <br /> Fill out'application completely. <br /> O,wrier:&,Contractor sigri<back;of app(ication,.notarized <br /> If'over,$250Q,a Notice of:Comm®n'c®m®nti;is required. (A/C upgradewover$7500) <br /> ** .Agent(for.the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> ;OV.ER`THE COUNTER PERMITTING ,(copyof contract required): <br /> 'aiFo6fsifshingles Sewers Servicebpgrades A/C Fences(PlottSurvey/Footage) <br /> Driveways-Not over Counter if on public•roadways..needs ROW <br />