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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Owner Phone Number Owner Phone Number I Owner Phone Number I Date Received . - q -b' Owner's Name C!.ROSSROADS NIA TAL Cltu.. rt Owner'sAddress I 5.;<0'8 'bfk ST. I Zeph'fmi 11$, Fl. Fee Simple Titleholder Namel R \ '()(; S c tt R 1ST I 11 TV CE~-rt:R, 11\X.. I Fee Simple Titleholder Address II 7 I ~ JOB ADDRESS 5"Oto8 '3ft.. Ll LAC AV~. 1 CH-C?.sA-PEI'1I<~ ~ VA. ';(33;;l..5"- 3'&:;tO ~T. } z:.eph\lY-~llls 1 335"lf~ I LOT # I PARCELlD#lll-.;1..4>-~L-OO(D-l'2S300-0~:;J..O (OBTAINED FROM PROPERTY TAX NOTICE) c=J ADD/ALT D SIGN D MOVE D c:::J REPAIR D COMM D D FRAME D l-tEA-T"f- A/e- SUBDIVISION WORK PROPOSED [8j PROPOSED USE D TYPE OF CONSTRUCTION D DESCRIPTION OF WORK I C-H-A-r0GE"" OJ)"\ S --To"" BUILDING SIZE I SQ FOOTAGE I I HEIGHT I 111"'11111111111111'11111111111111111111111111'1111111"'11"'11"'11""'111'1111"'11"111'1"1111""'"1'111111111111111111111111111'11111111 NEW CONSTR INSTALL SFR BLOCK DEMOLISH OTHER STEEL I D OTHER I ,gL 1$ I 1$ I 1$ I ~ MECHANICAL 1$ I ;;;Z I 000. 00 I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo 11111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111 BUILDER I COMPANY SIGNATURE REGISTERED Y f N FEE CURRENT Y I N Address I License # ~~~~"i.~N~~ ~ ;~~:~: 1r;,~~DZ,~",;;-~'T~"f Addres~ License # PLUMBER I SIGNATURE I ELECTRICAL AMP SERVICE D PROGRESS ENERGY D W.R.E.C. D BUILDING VALUATION OF TOTAL CONSTRUCTION D PLUMBING VALUATION OF MECHANICAL INSTALLATION COMPANY REGISTERED Y I N FEE CURRENT Y/N J4zlw;f - COMPANY REGISTERED License # I BA+tf< '5 0AS +- A/e- I Y I N I FEE CURRENT I Y I N COMMERCIAL Address MECHANICAL l (' f L' "'; ~fl SIGNATURE ~ a....c ~ Address I OTHER I SIGNATURE Address I License # 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 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 on site, Construction Plans, Stormwater Plans wi 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. License # COMPANY REGISTERED Y I N FEE CURRENT YfN SIGN PERMIT iil~~~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 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