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813-780-0020 'Date Received City of Zephyrhills Permit Application Building Department Fax-813-780-0021 (\ \\\ ~ Owner'sAddress h~'-X5 ~ t{~S~ -\:)( , Fee Simple Titleholder NamJ Fee Simple Titleholder Address I I'~\~~S ~\\ .~~ ~"'\0\ \-~ \"Cc:f\1 PARCEL ID#I I 1$03\CjcS),~ 1$ 1$ 1$ D ROOFING FINISHED FLOOR ELEVATIONS Owner's Name JOB ADDRESS SUBDIVISION WORK PROPOSED PROPOSED USE TYPE OF CONSTRUCTION DESCRIPTION OF WORK BUILDING SIZE BUILDING ~ELECTRICAL 0 PLUMBING 0 MECHANICAL 0 GAS Owner Phone Number Owner Phone Number I Owner Phone Number I LOT# 10~ ~NEWCONSTR t::::j/"INST ALL D SFR OCK (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH ~DD/ALT D REPAIR D COMM RAME I OTHER I ~~\ 'C'\2\(Y ')1 I I I I D VALUATION OF TOTAL CONSTRUCTION AMP SERVICE o PROGRESS ENERGY D W.R.E,~, --2),{\L -:1\~C"1 VALUATION OF MECHANICAL INSTALLATION SPECIALTY D OTHER F 00 ZONE AREA DYES "r :;~ DNO BUILDER SIGNATURE ELECTRI SIGNATUR ;~:::.{R~~~t~~~~ .*~~ License# 1t5b~TI~~ ~1L:EE~'1:~ ~I Y/N License # I \ ~I Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N YI N FEE CURRENT License # Y I N FEE CURRENT License # YI N FEE CURRENT License # Address MECHANICAL SIGNATURE COMPANY REGISTERED Y/N Address OTHER SIGNATURE COMPANY REGISTERED Y/N Address 111"'111111'11 1111"11111111'11"1111111111111111111111111111111111111111111111'1111111111'111111111111111'11111111111"11111111"111111111'111' 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 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, I I I I I I I I I I I I . I I I I I I I I I I I I , I , I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I . . I I I I I I I I I I I I I I . I ~ I I I I I I I I I I I I I I I I I I I I I I I I II I I I I I I 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 NC Driveways Fences (Plot/Survey/Footage)