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813 -780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021 <br /> Building Department <br /> Date Received - /3'e 4. Phone Contact for Permitting -- <br /> Owner's Name 1 11111 • ..I 0 nl Owner Phone Number S73 7,2- — '/Q <br /> Owner's Address --CZ f ? 10 -t-42 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address a <br /> JOB ADDRESS 5-0 3 104 Ft' - LOT # <br /> SUBDIVISION Ti - :7 N Z H-(tt t 1S PARCEL ID# r/-)--6-4).-/— 00/0 --?/ o r 003 <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I MOVE 1 1 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [ I SFR I I COMM I I OTHER 1 I <br /> TYPE OF CONSTRUCTION I 1 BLOC K I `,p FRAME 1 1 STEEL I I OTHER I I <br /> DESCRIPTION OF WORK � 1D O ("' — (j J g- • - 14 64 -- E S <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> l) I BUILDING $ O' 3 f O ' o o VALUATION OF TOTAL CONSTRUCTION <br /> 1 I ELECTRICAL $ o AMP SERVICE 1 I PROGRESS ENERGY I I W.R.E.C. <br /> I I PLUMBING $ <br /> M VALUATION OF MECHANICAL INSTALLATION (l1 <br /> __-- <br /> 1 1 $ 49 <br /> I I GAS I Vr I I SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES I <br /> BUILDER COMPANY til L_ J � <br /> I. LV 1 C--E <br /> SIGNATURE REGISTERED Y/ N 1 EE CURRENT I Y/ N 1 <br /> Address I 1 (-( 7 1 (LS. rl w iq J. CL o.. 1, . �3 f 1 `j' License # CC -CA) Sd G1- <br /> ELECTRICIAN COMPANY <br /> 1 <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1 <br /> Address 1 License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y/ N 1 <br /> Address License # I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y / N 1 <br /> Address /� License # <br /> OTHER COMPANY 4 (c..- p V, Sk2vi C 3 <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1 l <br /> Address I License # I CC C � d- <br /> OS <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 (3) complete sets of Building Plans plus a Life Safety 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 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 /> 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 />