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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Re~eived Owner's Name Owner's Address I 3~\{ 2 \ S~J...\'-'\ A0e- Fee Simple Titleholder NamJ Owner Phone Number Owner Phone Number I Owner Phone Number I Fee Simple Titleholder Address JOB ADDRESS I (2,e \ D (' Q ~ \ n c, .. WORK PROPOSED E3 D D I NEW CONSTR INSTALL SFR BLOCK St ( ~ eA- l-..~ ':) n{- Se 0J I PARCELlD# I B D D P.ed.pshaJ LOT # SUBDIVISION PROPOSED USE TYPE OF CONSTRUCTION AD DIAL T REPAIR COMM FRAME D D D (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH OTHER I STEEL D I I I OTHER I DESCRIPTION OF WORK SQ FOOTAGE I BUILDING SIZE HEIGHT I .......11111...11................111....11........11........11...1............111.11.111.........111...11...........1111.......11..11.111..11.11.. D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION G2f ELECTRICAL 1$ \ 1...\ ~ :; , OD I AMP SERVICE D PROGRESS ENERGY D W.R.E.C, D PLUMBING 1$ I N I c- p.e ( S h o,Y"'\.SL- . D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo ......11...111.11.........111..........11...........11...............11.............11...11...........11........1111...........11.11.11.11....1111 BUILDER I SIGNATURE Address I ELECTRICIAul . rr- 1"-'1\. SIGNATURE'~~..)\1 ~ Address ~"l\q Gt~ S't. 2-lM1l& Pi . COMPANY REGISTERED Y/N FEE CURRENT Y I N License # COMPANY REGISTERED Y/N FEE CURRENT I Y I N License # I ECI.!Q:lI~~ "'3~~l.f~ I PLUMBER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT License # Y/N FEE CURRENT License # Y/N FEE CURRENT License # Y/N Address MECHANICAL SIGNATURE COMPANY REGISTERED Y/N Address OTHER SIGNATURE COMPANY REGISTERED Y/N Address 1.""'..."'11 "111111"1111'-"11'111'11111"11111'1111'11111111111"11111111"111111111111111111.'11111"'1111111..'11"111111."1111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster 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 I I I I I I I I ~ I I I I ~ ~ I I I I I I I I I I I I I I ~ I I I I . I . I I I . I I I . I I I I . . I I I I I I I I I I I I I I I I I I I I I . . I I I I I I I I . I I I I I I I I I . I I I I I I J I I I I I I I I I I i I I I I I I . I I I I I I I I I I ii' I I I I I I I I Iii Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) 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 (Front of Application Only) Reroofs Sewers Service Upgrades NC Driveways Fences (PloUSurvey/Footage)