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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 I ~ CJ :J.../ ~ Fee Simple Titleholder Namel Fee Simple Titleholder Address I //~ ,'')'''-1- 'S A-v-c - Owner Phone Number Owner Phone Number I Owner Phone Number I fl-C/5 Ms JOB ADDRESS : ., '1 ;;1..1 (. A Jc LOT # I PARCEL 10#/ /,::2 -.;1. 6-;2/ - 0 (.)-gz;-;)O c-~i2J- 0 D~ .?) (OBTAINED FROM PROPERTY TAX NOTICE) a NEW CONSTR B ADD/ALTO SIGN D MOVE 0 DEMOLISH INSTALL REPAIR o SFR D COMM D D BLOCK D FRAME D 1S."'Jic-c. Ufjy:L~ I SQ FOOTAGE I SUBDIVISION WORK PROPOSED PROPOSED USE TYPE OF CONSTRUCTION OTHER STEEL I D OTHER I DESCRIPTION OF WORK HEIGHT I BUILDING SIZE ITII""IIIIIIII"I""""""II"'III"'.""'III""1111111111111""'1111111'111111'111"'1111"1'11"11'("'IIII'I'lllfll"I"II'III'III'1111 PLUMBER SIGNATURE 1$ I 1$ /51)0. ~ I :: : VALUATION OF MECHANICAL INSTAllATION (C? g 1!2. '- ( / D GAS 0 ROOFING D SPECIALTY D OTHER "''-- ~ FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 1111111111111111111I111111111111I111II111I1111111111111111111111111111111I111111111111111111111111111111111I11111111111111111111111111111111111111 I I I I I I I I I I D BUILDING IAl ELECTRICAL D PLUMBING D MECHANICAL VALUATION OF TOTAL CONSTRUCTION AMP SERVICE ;<00 rKI PROGRESS ENERGY o W.R.E.C. .",,"~ j BUILDER I SIGNATURE Address I ~:t;;:~:N l1=/f ~ Address __ COMPANY REGISTERED Y/ N FEE CURRENT Y/N License # COMPANY REGISTERED I ~,,;,;;-1'" ~;;;;h>fy~L- License # I COMPANY REGISTERED Y/ N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y / N FEE CURRENT Y/N Address License # OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N COMMERCIAL Address License # 1111111111111111111111111111111111111I1111111111111111I1111I1111111111111111111111I1111111I1111111111111111111I11I11111111111111111111111111111111 RESIDENTIAL 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. SIGN PERMIT Di~~~ti~~~': . 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 (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW