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813-780-0020 City of Z phyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone C ntact for Permittin <br /> . _ <br /> Owner's Name r� '�1� `����a Owner Phone Idumber <br /> Owner's Address Sa3 ► 1 S� ��' Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address _ r- <br /> JOB ADDRESS a-3� �S �' LOT# � <br />-- SUBDIVISION---- - - - ---- -- ARCEL ID# �v a�a�- �0�O - (p[�_-0C)�'� __ _ <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e DD/ALT � SIGN Q Q DEMOLISH ' <br /> INSTALL EPAIR <br /> PROPOSED USE Q SFR ,-Q J OMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q RAME Q STEEL Q <br /> DESCRIPTION OF WORK �� C�(��G� �I C— W�R<< Z <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VAL ATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ ! C�L�� <br /> � � <br /> �ECHANICAL $ VAL ATION OF MECHANICAL INSTALLATION <br /> �,�.o� <br /> QGAS Q ROOFING Q PECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS LOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN CORIIPANY <br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY � <br /> SIGPlATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � COMPANY A�� C� ��Q�� S <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address P•U•WX 1 a-c� Z°�1i1`� 35�J �icense# �c-� J'l� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDERITIAL 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 te. Required onsite,Construction Plans;Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Facilities&1 dumpster;Site Work Per it for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal te. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster.Site Work Pe it 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 onstructlon. <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/ upgrades over g7500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner) ould be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application O ly) <br /> Reroofs if shingles Sewers Service Upgrades A/C ences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs RO <br />