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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner's Name J-t4j'l3!nc... ~ ~T '- L. c... Owner's Address 137e II ~ AA '0pJ\i,Lklll1" A. ~,......J, Fee Simple Titleholder NamJ I Owner Phone Number Owner Phone Number I Owner Phone Number I Fee Simple Titleholder Address I I 3e3~ L~1tef VIr{(&f 6LVb~ 2s()J.rdt,/k. Pi- 3JS-4 I I HMesT1l- ~ iN I PARCELlD#I:zf. ~~ ~l ~ <90;00 (OBTAINED FROM PROPERTY TAX NOTICE) E3 D I .-:-1 JOB ADDRESS SUBDIVISION ~ PROPOSED USE ~ TYPE OF CONSTRUCTION D DESCRIPTION OF WORK I IiJ:}'11k.1. BUILDING SIZE I ,j.!'o" oX 4" WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK ADD/AL T REPAIR COMM FRAME Ex/~77~ .4-M r'TlcN 6tJ'n) SQ FOOTAGE I s<s, 7 LOT# I 3'3 ~<?o D D D 12..1I D MOVE D DEMOLIsH SIGN OTHER I STEEL D OTHER I ,,~~ HEIGHT I I :i- 3 <.. 111..11......11........11...............111....................'...11.........111........11.111.............111...111.......1111111111111111111111 ~ VALUATION OF TOTAL CONSTRUCTION z.....J. .,' f~ ~ \.fY .~\"S:i'_~h I AMP SERVICE D PROGRESS ENERGY D BUILDING :: iOI 000 D ELECTRICAL D PLUMBING 1$ D MECHANICAL 1$ D GAS D ROOFING FINISHED FLOOR ELEVATIONS I 1 D D W.R.E.C. Noc.- e.C (\., r ~'1'C,(' A{C.4 Lie( Cer4, 1- "to .~ VALUATION OF MECHANICAL INSTALLATION SPECIALTY D OTHER FLOOD ZONE AREA DYES BUILDER SIGNATURE COMPANY REGISTERED Address 1.3it>1 vi ~S hi 4us $i, ~ ft 3 '3 (p7-~ I " ~.;:)~ COMPANY REGISTERED 13 \ ",e! ~ -)~~~ r--~ ~3 OTHER COMPANY SIGNATURE REGISTERED Address DNO l~eiW ~e CJN~~~ ~~IIJ. @ I YI N I FEE CURRENT I Y/N I License # I eRe. 13Z'" Is<f I I Y/N I ~4 License # I /!fR. 1.3012.4 8lP I @?I I ~ I I I ~c. ,4.\ L "'If e~fZ..t~ I Y I N FEE CURRENT DltJ,.J~f?- I YI N I Y/N FEE CURRENT License # (2c ki- .i 21 ~c..ttU '- I Y I N FEE CURRENT I Y / N I License # C4e. 1St 342.-2- Y/ N Y/N FEE CURRENT License # 111""1111'.'1111'1"."1111111'."'111111"1111'.'"1111'1.1'."1'11111'..."1111111111111".'.'111"'1'1.""""11111111'1.'1"'1111'1.""111 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 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. Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. RESIDENTIAL COMMERCIAL SIGN PERMIT 11.1 ~ II ~ I I I II I I . 11I1 I II I . I I I I I III I II ~ 1111 . II III. I II I . . I I I II I I . . . II I 111II . I I 11III . I III I I I I111 I I 1I11111 I I . I 1I11I1I ~ II i I I I I I 11I1II II III III' i I I1111II1 i Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A1C 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 (Plot/Survey/Footage)