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813-780-0020 City of Zephyrhllls t-'ermlI AppllCcHlUII Building Department Date Received Owner Phone Number Owner Phone Number I Owner Phone Number I Owner's Name Ro~~s Owner's Address I ~ I '2.. '2 Lf L (...~ c V\ A-\..JC Fee Simple Titleholder NamJ JOB ADDRESS Fee Simple Titleholder Address I I '3 <is'(,D () / 'jg~D<-f I SUBDIVISION I E3 NEW CONSTR D ADD/ALT D INSTALL D REPAIR PROPOSED USE D SFR 0 COMM D OTHER I TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I ;~~;~;;;~~~I~~". ~.,,~. ~.~..r.~, ~~ ~;;~~.1.. ~ ~,~." ~I:.: ;~~~~..I. ~~. ~...",...!......",......",....~ (\19 oM; A:vf. PARCELlD#IO"l -l.. ~- 2 )-00 'LA - 6 0006- 0070 (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D LOT # DEMOLISH WORK PROPOSED D BUILDING 1$ '2 q9<)/iJD I VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY D W.R.E.C. 0 PLUMBING 1$ I D MECHANICAL ~ I VALUATION OF MECHANICAL INSTALLATION D GAS ROOFING 0 SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO '1.111111'...1111....1.....,111111111.....1.111111..'1...'..11.......11'.11'11......11.....1111...111..11111.....1111111.111...11.11.............. PLUMBER SIGNATURE I I I I I Address License # I MECHANICAL I COMPANY I SIGNATURE , REGISTERED Y / N FEE CURRENT Y / N Address I License # I OTHER J A ~ d' -I COMPANY I $~H-j} ICtJ..i-V ttW ~ D~ ~ 7JM <- I SIGNATURE ~L{\J:5 REG..,...." I Y / N I FEE CURRENT I '" / N; .. Address I3JlO 10 S IL- S 2- /(.7 ~).II g-K' ..J4k A~H1/ ~ ( ..:r35'{ ~I License # I C' ~ C 6 M 7') 7 I IIIIIIIIIIIIIIII~IIIIIIIIII'IIIIIII'IIIIIIIIIIIIIIIIII11111111111111'11111'111'111111111111'111"111"11111'1111111111111111111"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 onsile, 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. BUILDER SIGNATURE COMPANY REGISTERED Y/ N FEE CURRENT Y/N Address License # ELECTRICIAN SIGNATURE COMPANY REGISTERED Y / N FEE CURRENT Y/N Address License # COMPANY REGISTERED Y/N FEE CURRENT Y/N COMMERCIAL SIGN PERMIT 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 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