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813 -780 -0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department pow <br /> Date Received LL LI <br /> Z J— / Phone Contact for Permitting -- <br /> Owner's Name ,?' ) t?± 7r ?)CI Owner Phone Number. • /' <I'.; x - 2.33 — 5e <br /> / 6c' Owner Phone one Nur�er ib <br /> Owner's Address ti`�'vjly ���(�C�/V `�J � ``,��,, _. <br /> Fee Simple Titleholder Name Owner Phone Number w ,.M. <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS y�p2 (O ©R A) 7 LOT # <br /> SUBDIVISION PARCEL ID# <br /> 15_24_2,1- w ,50 - UOr(�Q w/d <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT 1 1 SIGN I I MOVE I I DEMOLISH <br /> X INSTALL REPAIR <br /> PROPOSED USE FA SFR I I COMM I I OTHER I I <br /> TYPE OF CONSTRUCTION I I BLOCK I I FRAME 1 1 STEEL 1 1 OTHER I I <br /> DESCRIPTION OF WORK /4V57 !.— V X 12/ cs <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> I I BUILDING $ /179; , e2 VALUATION OF TOTAL CONSTRUCTION <br /> I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY 1 1 W.R.E.C. <br /> I I PLUMBING $ <br /> I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I I GAS 1 1 ROOFING 1 I SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 IYES 1 'NO <br /> BUILDER / / COMPANY /% / ?7 t ��Nri� <br /> SIGNATURE ! �,./�/ �.� / tom 1�� REGISTERED I Y / N I FEE CURRENT I Y / N I <br /> Address / I License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I <br /> Address 1 License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1 <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I <br /> Address License # F <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-0-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 />