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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner's Name (f)-q-Ol.P tJ IV) ~j iJ1 e--th ..CJ/~ ; '" cI L 3 8 & '5 5' s~ ~(? Owner"s Address Fee Simple Titleholder Namel Owner Phone Number Owner Phone Number I Owner Phone Number I Fee Simple Titleholder Address LOT # PARCEL ID#I I B D D 3 T~QF:-~J c~~ ~r H~t 11111111'1'1"1111111'1111.1111'1111111"11'11111'111'1III 11'11111111111'111'11'1111111'111111111111"'1111111'11'111111'11'1111111"11'111'111" o BUILDING 1$ o ELECTRICAL 1$ o PLUMBING 1$ o MECHANICAL 1$ to /J ~ /J d v _ t5 I c/. o GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO 111111111111111111111111111111111111111I11111111111111111I11I11111111111111111111111111111111111111111111111111111111111111111111I111I111111111111 COMPANY I I REGISTERED I I I I I JOB ADDRESS SUBDIVISION WORK PROPOSED B D D I ADD/AL T REPAIR COMM FRAME PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK DESCRIPTION OF WORK BUILDING SIZE D D D (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH I D OTHER STEEL OTHER I AMP SERVICE VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY D o W.R.E.C, VALUATION OF MECHANICAL INSTALLATION I Address I License # I I I1111111II1I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111 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. I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 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 BUILDER SIGNATURE Address ELECTRICIAN k \ (\ - I ~ \ 1\ SIGNATURE ~V.JV~ Address LPO. GC)'t ~6 J.. "'2~l".:d.Lc. (=t PLUMBER I SIGNATURE Address I C0MPANY REGISTERED COMPANY REGISTERED MECHANICAL SIGNATURE COMPANY REGISTERED Address OTHER SIGNATURE COMMERCIAL SIGN PERMIT Y I N FEE CURRENT Y/N License # R~-e~r ~ ec.'tv~c:....l 'F9-c I Y I N FEE CURRENT 'y I N I License # I (J(211oo, ~ s ') Y I N Y/N FEE CURRENT License # I L-"","~ I", .:L License # YI N Y/N FEE CURRENT Driveways-Not over Counter if on public roadways..needs ROW Fences (Plot/Survey/Footage)