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'I I 813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received -Or r , J I?"I ,q,S , r'" 4 #.1 . ~L" -z /1..1 ~3.5'1;l S::vKsra'tl..'I- e,gIEsl/:r'~ LOT # I PARCELlD#1 //-.24-~/-t)t)fO -11!.~()() .-#001-'. (OBTAINED FROM PROPERTY TAX NOTICE) D NEW CONSTR 0 ADD/ALT ~ SIGN D MOVE 0 D INSTALL D REPAIR o SFR D COMM 0 o BLOCK D FRAME gj l,4Ic/>.:.v9 .Ii O/s/tiJ;/,1'-r I/cc~ss . I SQ FOOTAGE I L, ..v ~~S r {~~~t~~r;;;s I $-Y'.1.3 f/)mt.Y -S"'1"U <<t. 7, .t-,(.lIs ~ 351/J I Fee Simple Titleholder Namel""::l7c,v I?~, rAe ~ s LW/ltl1 ;ivsT I ::;'rA~ 0( r Ze. JOB ADDRESS SUBDIVISION WORK PROPOSED PROPOSED USE TYPE OF CONSTR~CTlON DESCRIPTION OF WORK BUILDING SIZE I I I , I I I I , II , I , 11II , ~ I I I I ~ I II I . I II r I I II , I I II I I . . I I I I I I I I I (I I I I , I I I I II I I I , r I I I I , I II I , , II I r I II I , I II I I I I I , II II I , I I I I , I I I I I I I I I I I I , I I I I I I I I I I , . II I I I I I I 1$ I D ELECTRICAL 1$ I D PLUMBING 1$ I D MECHANIICAL 1$ I D GAS 0 ROOFING D SPECIALTY 0 OTHER - , ;'c!JL) ~ FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIIII11111111111111111111111111111I11111111111111111111111I111111111111111111111I111111111111111 D BUILDING Owner Phone Number /- 8/3 - 78''1- ,;1339 I ~tJS ,..vc:. s.s I Owner Phone Number /- ~ I g - 7 gg - D '700 Owner Phone Number I I INA DEMOLISH OTHER I/)C':;C.s5 ~AmP STEEL D OTHER I ~ /1-'/l:1 / HEIGHT I AMP SERVICE VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY D D W.REC, 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, I Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 onsite, Construction Plans, Stormwater Plans wI 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. BUILDER SIGNATURE G~ I COMPANY REGISTERED Address ELECTRICIAN I SIGNATURE . Address I PLUMBER I SIGNATURE I COMPANY REGISTERED COMPANY REGISTERED Address MECHANICAL I SIGNATURE . Address I COMPANY REGISTERED OTHER SIGNATURE Address RESIDENTIAL COMMERCIAL SIGN PERMIT Y/ N FEE CURRENT License # Y/ N FEE CURRENT License # Y/N FEE CURRENT License # Y / N FEE CURRENT License # Y/N FEE CURRENT License # Y/N Y/N Y/N Y/N Y/N .......111111......1111.111................111....111.........11.....11...11111.................111....11.1111......11111..111...................-11 Directions: . Fill out application completely. Owner & Contrpctor sign back of application, notarized If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) Agent (for the ~ntractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUN1ER PERMITTING (Front of Application Only) Reroofs . ,SEJwers ;. S~lVice Upgrades NC Fences (Plot/Survey/Footage) " DriVeWaY~NOOV~r Counter if on public roadways..needs ROW