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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner's Name Owner's Address OC Fee Simple Titleholder Namel Owner Phone Number Owner Phone Number I ?1-s Owner Phone Number I Fee Simple Titleholder Address JOB ADDRESS s% )o2( 1 it.. /l-uu ~ LOT # PARCELID#I \\-l~--~\- 00\0- 'O~OO'. 01'\.0 (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D SUBDIVISION I B CJ D ~p~\- s~Vjlu ,SQ FOOTAGE I ')(!)CX) WORK PROPOSED E1 I:Y1 D I L vn:J~ I I II , II r , I I pi' , . , , , .. , I , . I I I I I , , . I I . I . HI' 11111 .. If " I I I , .. I I " , . I I I I , . , .. . I I "'Ifill' II ~ I II n I PI .. . . I , r . " . I . II III I I .. I I " " . I , I I , fI . I I pi fill " I .. , PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK ADD/ALT REPAIR COMM FRAME DESCRIPTION OF WORK BUILDING SIZE D BUILDING l$l.\')oCJ.O J I D ELECTRICAL 1$ I D PLUMBING 1$ I D MECHANICAL 1$ I D GAS ~ ROOFING 0 FINISHED FLOOR ELEVATIONS I I D o D DEMOLISH I D OTHER STEEL OTHER I HEIGHT I AMP SERVICE VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY D D W.R.E.C, VALUATION OF MECHANICAL INSTALLATION SPECIALTY D OTHER FLOOD ZONE AREA DYES License # 11I1I111111111I 1111I11111111111111111111111111111111I111111111111111111I1111111111111111111111111111111111111111I11111111111I11111111111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new cOllstructlon, Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Sill Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslons/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 onslte, Construction Plans, Stormwater Plans w/ Slit 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. 11111111111111111111111111111111111111111 J J I J 11111111111 J I J 1111111111111111111111 11111111111111111111111111111111111111111111111111111111111111111 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 leller from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC BUILDER SIGNATURE Address ELECTRICIAN SIGNATURE COMPANY REGISTERED Address PLUMBER SIGNATURE COMPANY REGISTERED Address MECHANICAL SIGNATURE COMPANY REGISTERED Address OTHER SIGNATURE COMPANY REGISTERED Address COMMERCIAL SIGN PERMIT [::JNO '1~/~ FE~~R~ Y/N I License # Ieee 111 rro r I I I I I I I I I I Y / N FEE CURRENT License # Y/N FEE CURRENT License # Y/ N FEE CURRENT License # Y/N FEE CURRENT Y/N Y/N Y/N Y/N Driveways-Not over Counter if on public roadways..needs ROW Fences (Plol/Survey/Footage)