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813-780-0020 City d Zephyrhills Permit Application Fax-813-780-0021 Building Department Date Received Phone Contact for Permitting U 1 6-7 2 9 g oo d�1 /n� 00,g � 1 -�- Owner's Name -1 v 2 6 Fir r, U r t F D Ct L Z � Owner Phone Number Owner's Address 2q s)10 To ?r' QOG d lJe sl q 0vtoel Owner Phone Number Fee Simple Titleholder Name D W } n�_ 40 n I n 5 Owner Phone Number is Fee Simple Titleholder Address 2-1010 'FOP Cr' 12.04 d tjesfe C%Au 61 Florlda 335�{S JOB ADDRESS 4 05 2 6 (�+I Y D r Du 4 2� r h a 1 tS �Or/J Gi LOT# SUBDIVISION �- PARCEL ID# 13-26-21'd000-,0016 J _ 0G Z Z (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED R NEW CONSTR R ADD/ALT SIGN = = DEMOLISH INSTALL REPAIR PROPOSED USE = SFR = COMM = OTHER TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL DESCRIPTION OF WORK hli n c e 6 U-f co d a I etinAS O n re--t.- ,n eerea roof a m efw ( io! BUILDING SIZE �-�X�0® SQ FOOTAGE �$Oa HEIGHT ( 6 0+ UILDING $ S@ VALUATION OF TOTAL CONSTRUCTION =ELECTRICAL $ N A AMP SERVICE = PROGRESS ENERGY = W.R.E.C. =PLUMBING $ Ja I MECHANICAL $ 1,J t\ VALUATION OF MECHANICAL INSTALLATIO =GAS = ROOFING Q SPECIALTY = OTHER ® v FINISHED FLOOR ELEVATIONS A FLOOD ZONE AREA =YES NO BUILDER h1?jaq.)J1, - �J 1 COMPANY - COr15SIGNATURE J� REGISTERED L& N J FEE CURREN Address I License# ELECTRICIAN COMPANY A SIGNATURE N A REGISTERED Y/ N FEE CURREN Y/N Address 7771 License# PLUMBER COMPANY A SIGNATURE N A REGISTERED Y/ N FEE CURREN Y/N Address License# MECHANICAL COMPANY /%/LA SIGNATURE N A REGISTERED T/ N FEE CURREN Y/N Address License# OTHER COMPANY N SIGNATURE I I REGISTERED / N FEE CURREN Y/N Address License# 1111111111111111111111111111111111111111111111111111111111111111111 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. `PROPERTY SURVEY required for all NEW construction. . . . . . . . . . • . . . .■ ■ i ■ ■ i i . . . . . . . . . . . . . . . .■ ■ ■ ■ ■�■ ■ ■ i ■ �■�■�■ �®Pi�■ ■ �i ■�i . i i i i i i i i i i . . . i I�ITi i i�i.i�i� Directions: Fill out application completely. Owner&Contractor sign back of application,notarized If over$2600,a Notice of Commencement is required. (A/C upgrades over$7600) Agent(for.the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (copy of contract required) Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW