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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Recelvel! JOB ADDRESS Fee Simple TItleholder Address I I I Owner phone Numb~r Owner phone Numb~r I I Owner Phone Numb~r I I Owner's Name Owner's Address Fee Simple Titleholder Nam~ ,J./1r2r rf!..- LOT t# SUBDIVISION 5717-~ I PARCELlD#114 - 1..lR -.;2..\ -lao, Cl -0\000 -D\lO (OST AINED FROM PROPERTY TAX NOTICE) E3 NEW CONSTR r:=J ADD/ALT D SIGN D I MOVE D INSTALL D REPAIR PROPOSED USE D SFR 0 COMM 0 OTHER I TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D r OTHER I DESCRIPTlONDFWORK I Uf O/Z/lOI~ 5 Qcu,/ /#E7P'L jffZ=~ BUILDING SIZE I I SQFOOTAGE I I I HEIGHT 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 WORK PROPOSED DEMOLIsH I I I D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION .1 I }!Xi ELECTRICAL 1$ I AMP SERVICE 2 to W PROGRESS ENERGY 0 W.R.E.C. I D PLUMBING 1$ I D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION D GAS D ROOFING 0 SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO ,1111111111.111111111111111111111111111.1111111.11111........1111...111...11......111........111.111..11111'.1.1"",1.1.11..111111111.,111....111 I License # I I ~e5L~ C/~GL ELGZ-rl I t!J N FE CURRENT Y / N I License # I E/l, c>~g&. cr I I I I I I I Y/ N FEE CURRENT Y/N Address ocv~ COMPANY REGISTERED BUILDER SIGNATURE Address ELECTRICIAN SIGNATURE PLUMBER SIGNATURE COMPANY REGISTERED Y / N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y/ N FEE CURRENT Y/N Address License # I COMPANY REGISTERED Y/ N FEE CURRENT Y/N OTHER SIGNATURE Address License # III , HI" " II" ,,,.,,.,, I . III n , pi 111111111 III r ,. 11111 , III I " , I 11111 ., I .. 111111 t 111111111111111 " 1111111111 ., , 11111 I 1111 rr 11111111111111111111 n I RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onslte, 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 onslte, 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. . 11111111.111111111111111111111111111111111111111....11111..I.IIIIII,IIIIIIIIII.I.llllllliillllllilllllllllil1IIIilillllllllilllliliiiliiiiillillii 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 NC Driveways Fences (Plot/Survey/Footage)