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Fax-813-780-0021 813-780-0020 City of Zephyrhills Permit Application Building Department ~5(P Date Received Owner's Name .:::so Owner'sAddress 165t.tD c;2.L\-trJ S\-f~~ Fee Simple Titleholder Namel z.j4.j \, -::. Owner Phone Number Owner Phone Number I Owner Phone Number I Fee Simple Titleholder Address I 15540 I d4--\-n BUILDING SIZE I I SQ FOOTAGE I I HEIGHT 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 r . I , I , . I I I ; , I I I I I r 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 czr 1$ I . g.Ho5. DC;) . D ELECTRICAL 1$ I D PLUMBING 1$ I D MECHANICAL 1$ I D GAS 0 ROOFING D SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII1111111I11111111111111I111II1111111111111111I1111111111II111111111I11111111111111111I1111111 COMPANY ~. - ~~~-\ ~r~~9~ I REGISTERED ~N ~r FEE CURRENT f I N I License # I I I I I I 5-\-. I B D D JOB ADDRESS PARCELlD#1 ~ SUBDIVISION ADD/ALT REPAIR COMM FRAME WORK PROPOSED B o o I QerDDt: PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK DESCRIPTION OF WORK LOT # (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE 0 DEMOLISH o o I D OTHER STEEL OTHER I BUILDING VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY AMP SERVICE D D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. Di~~~ti~~~': . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . , . . . . . . . . . . . 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 A1C Fences (Plot/Survey/Footage) BUILDER SIGNATURE Address ELECTRICIAN I SIGNATURE . Address I PLUMBER I SIGNATURE Address I COMPANY REGISTERED COMPANY REGISTERED MECHANICAL SIGNATURE Address OTHER SIGNATURE Address RESIDENTIAL COMMERCIAL SIGN PERMIT Driveways-Not over Counter if on public roadways..needs ROW Y I N Y/N FEE CURRENT License # YI N Y/N FEE CURRENT License #