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813-780-0020 City of Zephyrhllls t-'ermlI AppllCClllUII Building Department S ~-1L Date ~eceived L.-\- 2.. Owner's Name 12 c)b-l- cl Owner's Address I to C? L.f I Fee Simple Titleholder NamJ of.o 10dCL. Ac ~ : l'\ tJ, \.--oL \62- b v Owner Phone Number Owner Phone Number I Owner Phone Number I Fee Simple Titleholder Address JOB ADDRESS i (j qL\ I ~ <..;>.(' ~'" Lc<- \t- o Dv LOT # SUBDIVISION I PARCEL 10#1 (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTR El ADD/ALT D SIGN D MOVE D DEMOLISH INSTALL REPAIR PROPOSED USE D SFR 0 COMM D OTHER I TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I DESCRIPTION OF WORK I~~ ~c...\~ p~ BUILDING SIZE I SQ FOOTAGE I I HEIGHT I 1....111..11111..111.......1111.......11...111....1.....11..1111111.1..........1111,....11111...111...111111.1111..111..11..........1111.11111111. g-' BUILDING D ELECTRICAL D PLUMBING D MECHANICAL D GAS 1$ L-\32S,a-o 1$ 1$ 1$ D ROOFING FINISHED FLOOR ELEVATIONS VALUATION OF TOTAL CONSTRUCTION AMP SERVICE o PROGRESS ENERGY D ~ W.R.E.C. VALUATION OF MECHANICAL INSTALLATION o SPECIALTY D OTHER FLOOD ZONE AREA DYES DNO BUILDER SIGNATURE /77 r 72. 1173(, U-J, ~~ I=l~ COMPANY IUISC0~+- S~ ~,C...SL- REGISTERED I Y I N I FEE CURRENT I Y I N I _ A("otJ\::::Eil~~ l4. yL License # I s c c... \ "3 \ I '-l q (" 9 61 I COMPANY I I REGISTERED Y I N FEE CURRENT Y I N I I I I I I I Address Dc..... dU-- Av-e... ELECTRICIAN SIGNATURE Address License # COMPANY REGISTERED PLUMBER SIGNATURE Y I N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y/N Y/N FEE CURRENT Address License # COMPANY REGISTERED OTHER SIGNATURE Y/N FEE CURRENT Y/N III I 1 111111111' , 11111111 11111111111 1 III1I n IIII1II n 1111111111111111111111 " 11 , 11111111111111111 1111I1I11t lilt III , . II till U I .. I III P I III P ,. " n III Address License # 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 onsile, 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 II II I I II I ~ I I I I I I I I I I I I . II II . I I II . . I II I I I ~ . i I II I I I ~ I ~ I II . I III III II II II11 I II III II I . I I I . I I III I III I I II I I I II I II III II I I I II I I I II I I I I I I II III I II I I i I I I I II 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 (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW