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813-780-0020 City of Z phyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date�teceived Phone C ntact for Permitting -- <br /> Owner's Name ��� Owner Phone Number /�� �35�� <br /> Owner's Address �7-� �! � � � /�i Owner Phone Number � <br /> Fee Simple Titleholde�Name Owner Phone Number <br /> Fee Simple Titleholder Address <br />- JOB ADDRESS ,j� r�T . 3�J` LOT# � <br /> SUBDIVISION ARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) i <br /> WORK PROPOSED e NEW CONSTR B DD/ALT � SIGN � 0 DEMOLISH <br /> INSTALL EPAIR <br /> PROPOSED USE Q SFR Q OMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK �. RAME � STEEL 0 <br /> DESCRIPTION OF WORK �NS��� s'�� � �����`� r'"l�C� �L/'�G� L <br /> BUILDING SIZE �S� SQ FOOTAGE HEIGHT <br /> �BUILDING $ VAL ATION OF TOTAL CONSTRUCTION <br /> LECTRICAL $ . AMP SERVICE �� PROGRESS ENERGY ' Q W.R.E.C. <br /> � <br /> OPLUMBING $ e j ���� <br /> OMECHANICAL $ VAL ATION OF MECHANICAL INSTALLATION <br /> �I <br /> �� � y <br /> OGAS 0 ROOFING Q PECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS LOOD ZONE AREA DYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# , <br /> ELECTRICIAN COMPANY ��!/ G�" "�(/"�'� L^Z G�-��''"� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 2 s�7� /�'� � �! L aF License# � C" �3 a�Sr��� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <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 ate. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Pe it for subdivisionsAarge 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 ate. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Per 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 onstruction. <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. ( C upgrades over$7500) <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(PlobSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs RO <br />