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Date Received City of Zephyrhills Permit Application BUilding Department /) ra~ 3/3 Fax-813-780-0021 813-780-0020 Owner's Name A rr Owner's Address I 3 q 114- Am eA-h ~ sf Wa. y Fee Simple Titleholder Nam~ Fee Simple Titleholder Address I 33 SlfO Owner Phone Number g /3 -11 Owner phone Number I Owner Phone Num~r L JOB ADDRESS LOT# I d20 h WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK PARCELlD# d. -;J.k;-d, - OO~O- 00000 -eJ,ObO (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D D o D Roo rn dSfp t/1 I HEIGHT I DEMOLIsH SUBDIVISION DESCRIPTION OF WORK e' D ~ I Room Adc1ih'oYl t- 2iJed SQ FOOTAGE I 3:;';;' if EJ D D ADD/ALT REPAIR COMM FRAME OTHER I STEEL D I I I PROPOSED USE TYPE OF CONSTRUCTION OTHER I Shed bb rp I BUILDING SIZE .........11.....11111..111......11...11.....11.....111......1111..111........111...11111...11...11..........111.11.111.................111........ ~ BUILDING 1$ I ~ 5""tJO. t:n7 CXJ ELECTRICAL 1$ ~ PLUMBING 1$ D MECHANICAL I' VALUATION OF MECHANICALlNSTAUATlON ' " \ ... \ .i;... . G- D GAS D ROOFING 0 SPECIALTY D OTHER \'\'~ -~.- FINISHED FLOOR ELEVATIONS I . I. FLOOD ZONE AREA DYES DNO t<.o\-v _ (;to.crt:> I"""""""""""""""""""""""""'"."..."",.."".,.,.""",."..".,',.."...,',...,."..,",.."...,"'....,'~:~~. r. / ~ ~ ~ . J')U. ,'I:> I ~U~ VUJl(J4- VALUATION OF TOTAL CONSTRUCTION AMP SERVICE t=J PROGRESS ENERGY o W.R.E.C. pJOC- _ BUILDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN ~t~ SIGNATURE - :) ~ ~-3'j~ -~ I License # COMPANY REGISTERED M~r()~ E7ecfr/~ I (Y. N I FEE CURRENT I@ N License # I ~&f~~,e~~~NT License # I Address PLUMBER ~~ SIGNATURE :~ ~ '~1J.~ COMPANY REGISTERED (~/~I Address MECHANICAL SIGNATURE Y/N Address OTHER SIGNATURE Y/N Address '1"""."'111 "IIIIlllllllt",I"IIIIIIIIIIIIIII'IIIIII""'IIII'"111111111111111111111111111111111111111111.11111.111111I1111IIIII11111111111 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 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. . 1111111111111111111111111111.1111111111111111111".1111ll,llllllll.,IIIIIIIIIII,lllllllliillllllillillllilll1IIIililllllllliillliliiiliiiiiliillii Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (AfC 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 AfC Driveways Fences (PloUSurvey/Footage)