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813 - 780 -002Q City of Zephyrhills Permit Application Fax -813- 780 -0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permitting -- <br /> mattaamatmatamitor ' <br /> Owner's Name •T 'B� r m � n 1 Owner Phone Number I R !' <br /> �Q L q 7 I 5 <br /> Owner's Address 5 "' r, 1(0 + Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address f - �- \ <br /> JOB ADDRESS .Jl� 1 + m 0 <br /> LOT # 2 <br /> SUBDIVISION PARCEL ID# II- 21.Q - 21 - CO to - 11 ac,C 0 a t v <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE n SFR 1 1 COMM = OTHER I EPn hns+ia fl kkim cm I <br /> TYPE OF CONSTRUCTION n BLOCK n FRAME n STEEL n OTHER I I . <br /> (� ' woLjIK Ct <br /> DESCRIPTION OF WORK in al-cot 11 t' 0-C ( i h 1 ` C1 b b l e ( ce nc w 1 I <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> Eltk fltEEl •.:.:. '.. :111. ... _ 1.1 . 11'1.11:11 :•:.... 1' 111'111 ...... I�IttEIL <br /> In BUILDING $ 3 9 5,7: vv VALUATION OF TOTAL CONSTRUCTION <br /> I 1 ELECTRICAL $ AMP SERVICE n PROGRESS ENERGY n W.R.E.C. <br /> - <br /> I 1 PLUMBING $ <br /> I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> GAS n ROOFING I 1 SPECIALTY I 1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES nNO <br /> BUILDER COMPAN v3 ' /� -j'1 e <br /> SIGNATURE � � / REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I <br /> / / <br /> Address ` Z Da ff� zy. gw <br /> License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I <br /> Address <br /> License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT 1 Y/ N I <br /> Address <br /> License # <br /> ..1. •:.1...,.,.., 1 <br /> .:, ........,••rlia:i?il 1:1::.1:: V ..1:La:.•::: cal le3 l ....1' °ri'::::r: :... ...., ^h 3: 11 Er4IfiffiElfgEtt <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 /> 11........... •• .. _.._. , y- aferi ""rsnxmu' €ggRE€ ICE€ €€ff€ P EEIE € € €€i'g'gurcrffEFFE IH I ITN € €illIIiIII€ <br /> c . •.' 11 . •1.11....1 Y.... <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 />