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i <br /> s�aaeo-oozo • `' City of Z phyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> i I <br /> Date Received �� ZCI -I phont ontact for Permitting � ` �� - �/�� <br /> ' �3�3-�8o - 8�1uo <br /> Owners Name �O(L�0 - A 1(, L L LI�1 �, � Owner Phone Number <br /> Ownet's Address �1 S� �fj l,(,A LJA. �.o �f�' yb3 Owner Phone Number <br /> � <br /> Fee Simple Titleholder Name �,-O�l�� EA 1(,A C V�N� Owner Phone Number <br /> Fee Simple Titleholder Address ���� �A E LA �A• �I NO Q f.�1�s ��.. 3 y�p� <br /> JOBADDRESS �Qb Tflo��„n �� � (i��(� ��1�� L 33�`��- LOTq �A <br /> i <br /> SUBDIVISION � PARCELID# OZ-Z.�O�L1- DO�(�� OOOOO�Op1 0 <br /> � (OBTAINED FROM PROPERTY TAX N TICE) <br /> WORK PROPOSED e NeW cON57R ADD/ALT j� S�L Q � DEMOLISH <br /> INSTALL REPAIR A <br /> PROPOSED USE Q SFR COMM I Q OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME i 0 STEEL Q <br /> i 7^ � <br /> DESCRIPTION OF WORK � 0�1 'C� 1`S �F • S�Nb� o w l'��-� S\T E � Jj�l.� �E S <br /> BUILDING fiIZE W�cl+� S"-o SQ FOOTAG ��"��I HEIGHT +I- 1����� <br /> � Sc�\� <br /> UILDING $1�O D D� � VA UATION OF�TOTAL CONSTRUCTION � , <br /> �//ECTRICAL $1�O O O O A P SERVICE -1�� � PROGRESS ENERGY Q W.R.E.C. �����l'���( <br /> ^ ,_ e �� � � <br /> �PLUMBING $ 3 S O Q O �����vw ���� <br /> �MECHANICAL $ 1 r QO� V LUATION OFiMECHANICAL INSTALLATION �,J�C <br /> I 10J � ! ,� <br /> OGAS Q ROOFING Q SPECIAL"f i Q OTHER L� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �\� ��� � <br /> I � � ����� <br /> i <br /> BUILDER � ���D� �OMPANY WAI.(,RCE-� SSaC.il�TES L�-L <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address yZ5 M•L'k'`��D �• N� S�• � {il� �1��j License# C'�� �5�3°��� <br /> ELECTRICIAN �� s�i � COMPANY Cz � C .P �1C � 'Q � �G � li <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address i License# G <br /> PLUMBER �COMPANY ������J �«✓���rG �~�• I <br /> s�I�/�'/a.9L—( �} �G7�� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 1 N <br /> Address i License# C F �G S 7 1 II <br /> �l,l� MECHANICAL � � l �COMPANY I <br /> SIGNATURE l� REGISTERED Y/ N FEE CURRE� Y/N <br /> �-il`r <br /> ��G�� �� Address i License# <br /> � �/�, OTHER COMPANY <br /> � ^ �V SIGNATURE REGISITERED Y/ N FEE CURRE� Y/N <br /> V1" <br /> Address I License# <br /> �, Illlllllllllllllllllllllllllllllllilllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PI ns;(1)sel oflEnergy Fortns;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submi tal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Faciiities 8 1 dumpster,Site Work ermit for sutidivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans lus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum len(10)working days after submi tal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Atlach(2)sets of Engineered Plans. � <br /> ""PROPERTY SURVEY required for all N W construction. <br /> Directions: I <br /> Fill oul application completely. i <br /> Owner&Contractor sign back of application,nolarized � <br /> If over$2500,a NoNce of Commencement is required. (AIC upgrades aver$7500) <br /> " Agent(for the conlractor)or Power of Attorney(for the ow er)would belsomeone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicati n Only) I <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footaga) <br /> Driveways-Not over Counter'rf on public roadways..need ROW � <br />