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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received 5 --, L\ 0 () h t Ma. 11~rrll'\ Owner's Name Jl 0 ue r t 1'\ f I~ rr1 Owner's Address I t-f l3 ~ ltJ T( Y\c..lo eO' Willi Fee Simple Titleholder Namel \-0.'1 Z.H (//~I 71 ~3~ I JOB ADDRESS Owner Phone Number Owner Phone Number I Owner Phone Number I 0/3' '~3-/Jb ~ ~ ~I ~ _ 991- dCJ;>,;)~f1 ~\"OJ "2> I ~ - 917- / If ;)"j e.u.C Fee Simple Titleholder Address h" f s :; I ''535'1./;) PARCELlD#1 t 5-"1.:. ~").I - o~oo -OOlXJtJ - D070 (OBTAINED FROM PROPERTY TAX NOTICE) SIGN 0 MOVE 0 o NEW CONSTR ~ ADD/ALT 0 D INSTALL D REPAIR PROPOSED USE ~ SFR D COMM 0 OTHER I TYPE OF CONSTRUCTION @. BLOCK ~ FRAME 0 STEEL 0 OTHER I DESCRIPTION OF WORK I Ct d d lYlj h e,-l r"M om BUILDING SIZE I d-d- It Xc::lV /t I sa FOOTAGE I 1.1 0 it? t./ I HEIGHT I d (p I 'I" I TTTlTTIIIIIIIIIIIIIIII' I' '1111111' '11111111111" 1111111111111111111111 1 11111111111111111' 1111111111111111111111111' 'III" 111111' 1'111111111' '11111 1$ /'1, 7bO 00 I D ELECTRICAL 1$ v,'-l-5"oOi:> I D PLUMBING 1$). \ rOO 00 I D MECHANICAL 1$ ~~7CO I D GAS 0 ROOFING D SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I ~ 10 . 10' I FLOOD ZONE AREA DYES [S(INO 11111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111 COMPANY I-! tJ7::U~ ./r7..( J-u OA REGISTERED Y / N_ I FEE CURRENT Y / N I SUBDIVISION WORK PROPOSED D BUILDING LOT # DEMOLISH AMP SERVICE VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY D D W.R.E.C, )Joe ~ VALUATION OF MECHANICAL INSTALLATION PLUMBER SIGNATURE Address I MECHANICAL I /1\AA ~ SIGNATURE ~ Address I OTHER r: SIGNATURE ~ Address I License # 111111111111111111111111111111111111111111111111'1111111111111111111111111'111111111111111111111111111111111111111111111111111111111'111111111111' RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new conslruction, 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 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 {l L SIGNATURE -:. ."{~~ Address t( ~ ELECTR~~~ ~~ SIGNATURE . ~ . Address J;Jn~ H-~ COMPANY REGISTERED COMPANY REGISTERED H~ COMPANY REGISTERED COMPANY REGISTERED COMMERCIAL SIGN PERMIT License # Lf(/~_. License # I Y/N ,ff~ 1 Y/N License # I~ Y/N License # Y / N Y/N FEE CURRENT Di~~~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 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 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 . 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 NC Fences (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW