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813 -780 -0020 City of Zephyrhills Permit Application �" Fax-813-780-0021 Building Department 9 02 0 Date Received. Dc 09 Phone Contact for Permitting -- EMI Owner's Name MIA ' t ' _ 1t J u j ' S Si- ', Owner Phone Number O 0 U -`'�� Owner's Address 3 e 0 le IA-ft- 1" ► U e Z IA 71'A . / 47 Owner Phone Number Y 1.3 9 7 0 v ("3 7✓litiq Fee Simple Titleholder Name . bd1 '1 / Z 41 % Owner Phone Number Fee Simple Titleholder Address h r _ / 7 JOB ADDRESS 3 6'0 I `V k I Ai c i__ e i r' r rl S - 7 1 2_5 va LOT # SUBDIVISION PARCEL ID# !/ 24 ~ 21 .00(0 -26'000 - 0 / 80 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED j NEW CONSTR ADD /ALT I-1 SIGN n MOVE I I DEMOLISH INSTALL REPAIR ( PROPOSED USE 1 tr1 SFR I I COMM 1 ---- 1 OTHER I TYPE OF CONSTRUCTION F BLOCK I I FRAME I I STEEL n OTHER 1 I 1 DESCRIPTIONOF ORK I( . i \_S. BUILDING SIZE 0 ) (1 SQ FOOTAGE HEIGHT ( I I BUILDING $ 6 VALUATION OF TOTAL CONSTRUCTION I I ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I W.R.E.C. I I PLUMBING $ I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS I I ROOFING 1 I SPECIALTY I I OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I I1 BUILDER _ COMPANY OYl ( ow I e SIGNATURE / REGISTERED (-1-o Y/ N I FEE CURRENT I Y / N I Address License # ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I Address 1 1 License # PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I Address I License # I MECHANICAL COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address I License # I I RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects 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. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW