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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received II; II' I a "" fVl J <:::::> b ~-? ..s I-f'+~ 5+ Owner Phone Number Owner Phone Number I Owner Phone Number I 521-07 - Owner's Name Owner's Address I S.3.9 0 Fee Simple Titleholder Namel Fee Simple Titleholder Address - JOB ADDRESS 5.33D ~.:!!i s:f LOT # PROPOSED USE TYPE OF CONSTRUCTION B D D I If; .:;. +-0.. (( I PARCELlD#1 \\ -2lo-21- 00\0_ c::AfOO -01 \S (OBTAINED FROM PROPERTY TAX NOTICE) NEW CONSTR B ADD/All D SIGN D MOVE D DEMOLISH INSTALL REPAIR SFR D COMM ~ OTHER I .:5/+FD BLOCK D FRAME D STEEL D OTHER I SUBDIVISION - WORK PROPOSED - DESCRIPTION OF WORK qi-i'::(O( sh <e- d BUILDING SIZE 8 J' x f() / SQ FOOTAGE I g'CJ HEIGHT I 7./15 rr Tnllllllll"'III"II"'III'III"""'III'III""III'"""1"1""""""1"""1""11"'111"""'1"1'""11"""""""""""""""'11 - D BUILDING I~b" <)1 IJ '1 dlJ ~ I VALUATION OF TOTAL CONSTRUCTION 1$ I 1$ I 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I 'I FLOOD ZONE AREA DYES DNO IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIIIIIIIIIIIIIIIIII~IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111111111111111111111111111 -BUILDER L-)~G-.-v:--r-r, ~, ~. COMPANy-I ~~ e 21 cu n err" SIGNATURE 1 REGISTERED I Y / N I FEE CURRENT Y / N D ELECTRICAL D PLUMBING D MECHANICAL AMP SERVICE D PROGRESS ENERGY D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION ELECTRICIAN SIGNATURE COMPANY REGISTERED License # Y/N FEE CURRENT License # Y/N FEE CURRENT License # Y/N FEE CURRENT License # Y / N FEE CURRENT Y/N I I I I I I I I I I Address Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N Address MECHANICAL SIGNATURE COMPANY REGISTERED Y/N Address OTHER SIGNATURE COMPANY REGISTERED Y/N Address 111111111111111 RESIDENTIAL License # 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 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 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 on site, 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. COMMERCIAL SIGN PERMIT 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 . . . 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 (PloVSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW