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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 ~ate Received 5 t./ 0 / Owner's Name KlcHfl.tVowner's Address ISh () 7 / 7 t/; Fee Simple Titleholder NamJ Owner Phone Number Owner Phone Number I Owner Phone Number I /;Jd () Ly;LJOR- ~~;} f Fee Simple Titleholder Address I ~BADDRESS IS~m~ I LOT # WORK PROPOSED B D D I B D D 11V\s-\cU-SL PrUIY'-~ <) SQ FOOTAGE I PARCEL 10#1 SUBDIVISION (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH PROPOSED USE TYPE OF CONSTRUCTION / DESCRIPTION OF WORK NEW CONSTR INSTALL SFR BLOCK ADD/All REPAIR COMM FRAME D D OTHER D STEEL D ~~~ I HEIGHT I OTHER I BUILDING SIZE .1111...11....11....11........11..........111....1111.......................111................................111........1111111....11111111..... D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. /(81 PLUMBING 1$ I D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO ~ I . . . I I I . . I I I . . . . . I I I . I . . I . . . I I . . I I I . . . I . . I I . . . I . I I . I I I I . I . I . . . . . . . I . . . . I . I . . . I I I I I . . . . . . I I I . . I I I I . . . . . . I . . I . . . I . . . . . I . . I I . I . . I . . I , . I . . . . . I . I I I I I I . if) ~ . BUILDER . c/~'GNATURE. . ~ )h" Address COMPANY REGISTERED t~~ I Y / N I FEE CURRENT Y/N License # COMPANY REGISTERED ELECTRICIAN SIGNATURE Y / N FEE CURRENT Y/N Address License # PLUMBER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # COMPANY REGISTERED MECHANICAL SIGNATURE: Y/N FEE CURRENT Y/N Address License # COMPANY REGISTERED OTHER SIGNATURE: Y/N FEE CURRENT Y/N Address License # 11'111111111111 1IIIIIrllll'II'I'II'I"'IIIII"I"I,IIIIII'II)I'I'I'111'111"'1'1111"'11111111111""11111111'1111111'111111111111111'1111111"11 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, IIIIIIIII~IIIIIIIIIIIIIII&IIIIIIII'I~IIIIIIIIIII'I,~IIIIIII..IIIII.~~IIIIIIII&IIIII.~.IIIII...IIIII~~~IIIIIII.I~~IIII.~&IIIIII.IIIIIIIII~.IIIIIIII 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