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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-51 ~-7/jU-UU:.!1 ,/ Date Received - :N)O& !AlA t"r6. Mf5AOCJIAJ CJCJlJ t-()CJP ,/ Owner's Name iJ{:J H;J /' Owner's Address I 3 f 7/ (.:, Fee Simple Titleholder NamJ Fee Simple Titleholder Address I / JOB ADDRESS '3AMG- LOT # I I i I r-- -- WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK I 8' o o PARCELlD#1 \~-a<o.a \ - 6\'-\-0- QOOO() - n\ ~O (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE 0 SUBDIVISION ADD/ALT REPAIR COMM FRAME D D D DEMOLIsH B PROPOSED USE D TYPE OF CONSTRUCTION D ./ DESCRIPTION OF WORK I ;8.e ,8oCJP BUILDING SIZE I I SQFOOTAGE I 'I HEIGHT I ,I . . . . . . . . . . . . . .. . . . . . . . . . . . .. . . . . , .. . . .. . .. . : . . . . . .. .. .. .. , .. .. .. . .. . .. . , .. . .. .. . , .. , .. .. .. . .. . .. . .. . .. .. . .. .. . .. .. .. . . .. . , . . . . .. .. .. . .. . .. . . . .. .. . / D BUILDING 1$ 1-0 00 dj' VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ D PLUMBING 1$ D MECHANICAL 1$ D GAS ~ FINISHED FLOOR ELEVATIONS I OTHER I STEEL D I I' I OTHER I AMP SERVICE o PROGRESS ENERGY D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION ROOFING o 1 SPECIALTY D FLOOD ZONE AREA OTHER DYES DNO 11"""""""'1""""""""""""""""""",."",."",.,..".".".".,..,.".""..",;""...,."..".........,.......,.......... COMPANY /1 +-'ca:::ne ~"--- REGISTERED I Y IN' I FEE CURRENT I License # I /:~~~~~RE ! riJ, ?LJ~ Address ELECTRICIAN I. SIGNATURE Address I PLUMBER I SIGNATURE Address I MECHANICAL I SIGNATURE , Address I OTHER I SIGNATURE Address I Y/N COMPANY REGISTERED Y/N FEE CURRENT License # Y/N FEE CURRENT License # YI N FEE CURRENT License # Y/N FEE CURRENT License # Y/N COMPANY REGISTERED Y/N COMPANY REGISTERED Y/N COMPANY REGISTERED Y/N 1111'11111111111111111'1111111'11111111111111111111,111111111111111111111111111111111111111111111111111111111111111111'1111111111111111111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onslle. 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 onslle. 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 conslruction, , 111111111111111111111111111111111111111111. . 111I11111 . . '1111111.11111111 III 1 I . I i 111111111 i i i 11111 i II i I111 i I i 11111 i I i I1111111I i III i II i i II i i jj II i Iii 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 conlractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner aUlhorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades Ale Driveways Fences (PloUSurvey/Footage)