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813.780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner Phone Numbe Owner Phone Number I Owner Phone Number I Owner's Name Owner's Address Fee Simple Titleholder NamJ JOB ADDRESS Fee Simple Titleholder Address I I Sip2- t( I <fM~el 7Y!d.-;e Ci LOT # .2. PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK PARCEL 10#11.2 - 2~ - 2/ - 03 iD - 0000() -6cg 76 (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D .........111....11........................111..............111..'1...................1111..................................1...111.111.11111111111 I B D D be;; oil.. A-#)it ,52 ~Cf I SQ FOOTAGE I B D D ADD/AL T REPAIR COMM FRAME D D D 30 DEMOLISH SUBDIVISION -- I- s.k. /.e.<: WORK PROPOSED OTHER STEEL I D OTHER I ~Ar HE~:r.J ./' BUILDING SIZE <1k~iBs' I DESCRIPTION OF WORK D BUILDING 1$ 2,7 21{, oS I VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C, D PLUMBING 1$ I D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION D GAS 0 ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS 1 I FLOOD ZONE AREA [::::J YES DNO BUILDER SIGNATURE Address License # I c:.cC o5f122 7 ELECTRICIAN SIGNATURE Y/N FEE CURRENT License # Y I N FEE CURRENT License # Y/N FEE CURRENT License # YI N FEE CURRENT License # Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N Address MECHANICAL SIGNATURE COMPANY REGISTERED Y/N Address COMPANY REGISTERED Y/N OTHER SIGNATURE Address 1111'1111111111 "tr'IIIIII'I"I)IIII.III'I.I)III.IIIII.II'.III"""1111111""1111111111111"""'111111111'1'111111""1111""'111111111111111 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 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 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 AlC Fences (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW