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.813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 ~ Date Received \\1 ' Owner's Address n\ ~'-\~~ "* QDc\~ \'C:{>'Q. ex- Fee Simple Titleholder NamJ Owner's Name Owner Phone Number Owner Phone Number I Owner Phone Number I JOB ADDRESS D D 6 ~ LOT# ~ \ I PARCELID#I3-\ -~'S~\ ~G-~'1C[) ~, (OBTAINED FROM PROPERTY TAX NOTICE) o SIGN D MOVE 0 o I Q\'~ffi\,,>m o HERI \. \ ~~ BUILDING SIZE I I sa FOOTAGE liCS00 I HEIGHT ~,./...."'.......................................,.......................................................................,.......".""", ~ BUILDING 1$ \~ ~'\..DC\ .&t; I VALUATION OF TOTAL CONSTRUCTION ~ECTRICAL 1$' I AMP SERVICE D PROGRESS ENERGY < D WR.E,C, . ~(\L ~~~cl. 1$ I 1$ I o ROOFING D SUBDIVISION WORK PROPOSED ~ NEW CONSTR ~ INSTALL SFR B CK ~DD/ALT t:::J REPAIR D COMM AME DEMOLISH PROPOSED USE TYPE OF CONSTRUCTION DESCRIPTION OF WORK PLUMBING MECHANICAL VALUATION OF MECHANICAL INSTALLATION D GAS SPECIALTY 0 FLOOD ZONE AREA OTHER FINISHED FLOOR ELEVATIONS DYES DNO BUILDER SIGNATURE "- " COMPANY REGISTERED ~~~~:R~~ 1~h l1~fuRi\''Ml \ ~ .1 N3-~ License# }~~l\~ I ;~~~:R~~ I '7~ l~ ~ s ~~~~ I ~ I License # I \ ~ '\ I I I I I I I ELECTRICIAN SIGNATURE Address PLUMBER SIGNATURE Y/ N FEE CURRENT License # Y/ N FEE CURRENT License # Y / N FEE CURRENT License # Y/N Address MECHANICAL I SIGNATURE . Address I OTHER I SIGNA TURE Address I COMPANY REGISTERED Y/N COMPANY REGISTERED Y/N I111 '" 111'1'11"'111"11111"'11111'11111'11"111"11111'111111111111'1111'111111'1111111111111111111111111'1111'1'111111'11111111111'11111"1111 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 j ! 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 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 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 J 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 I I , I I I I I I I I f Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (Ale upgrades over $5000) Agent (for the contractor) Dr 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 (Plot/Survey/Footage)