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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 -p 4.11 ~D Date Received Owner Phone Number OWner Phone Number I Owner's Name OWner's Address Fee Simple Titleholder Name JOB ADDRESS Fee Simple Titleholder Address I 15/39 Shady ge~-f " IAh~l K#J- JYu-/.P WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK I B D D L h / , 2 -= p J, )' r- h; J Is LOT # PARCEL 10#1 J 0 J.fo JJ ()O/ 0 0 9cr 00 . (OBTAINED FROM PROPERTY TAX NOTICE) ADD/ALT D SIGN D MOVE D REPAIR COMM D FRAME D 170/ , SUBDIVISION 0000 DESCRIPTION OF WORK B D D 1~5~+ DEMOLISH PROPOSED USE TYPE OF CONSTRUCTION OTHER I STEEL D BUILDING SIZE 1/6 X ..:20 1111111111111'111'1"111111111"11""111111"111"'111111111111"""""""1"11111111"'1'1111111111111111111111111111111111111111111111111111 up I Par/qJ....J~ . SQ FOOTAGE 1 8l.-t ,Old ~'r1i 111,'i h_uyc./Tur-'C. I HEIGHT I ~y 1 s"P....r;::,,... I I ~ir.1.:s OTHER I 1$ 3/30. t:rO I 1$ '.16 Y7T_ r7=-e->J-cr I 1$ Alo~~ 'Y' .iV~J",d.1 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO ~~:~~~:"""j" ~/ ""'."'" ;'"' :;.11: ~~~~I"'" ~~~::~";. :":': ':': ", ."': ': ~"': """"""""""""""""1 SIGNATURE :~,;;C- ~ _ . REGISTERED L Y / N I FEE CURRENT Y / N Address License # I I I I I I I I I D BUILDING VALUATION OF TOTAL CONSTRUCTION ELECTRICAL AMP SERVICE D PROGRESS ENERGY D_ ('- , \~.R.E.C, h~ D D .1 PLUMBING D MECHANICAL VALUATION OF MECHANICAL INSTALLATION ~/~Jtt 5~ +1~'~ ELECTRICIAN SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # PLUMBER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N License # 1111111I111I11111I111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111 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 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. 1111111111111111111111111111111111111111111111111111111I111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111 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 Address 11111111/111111 RESIDENTIAL COMMERCIAL SIGN PERMIT Fences (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW it' " I ..."',.: 111 '.