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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Phone Contact for Permlttln c/,h'-<.J Owner's Name Owner's Address Fee Simple Titleholder Namel Fee Simple Titleholder Address I 387/~ Owner Phone Number 3::1 7):}. I ilner Phone Number Owner Phone Number I ~;/~ }k LOT # I I I IJ,-<,S' I I JOB ADDRESS SUBDIVISION PARCEL 10#1 /1-).(, o. ;U- t!XJlo -; 0500- cx:::JJ. <0 (OBTAINED FROM PROPERTY TAX NOTICE) SIGN 0 MOVE D I D....... NEW CONSTR [=:J ozr INSTALL CJ ~ SFR c=J TYPE OF CONSTRUCTION D BLOCK ~ FRAME DESCRIPTION OF WORK I L ~ I ~O BUILDING SIZE ~SQ FOOTAGE I HEIGHT I G?'" ~~,~~:~~' .."", 'i~" ~~: '.'~ .~".."'.." i"'" ~~~~~~~ ~~' ~~~:.;: ~::~~;,:"""""""""""""""""""'" , WORK PROPOSED D D CJ (Ru-Y)\>e(") PROPOSED USE ADD/ALT REPAIR COMM DEMOLISH OTHER STEEL I D OTHER I D ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY D W.R.E.C. 0 PLUMBING 1$ I 0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION D GAS ~ ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO I I ' . I . . , I I I . I 1 I 1 ' I ' . I I I I I I I 1 I . I I I I I I I . I , I I 1 I , I" I , , , I I I I I II , I I I 1 1 ' , , II I I II II III II' , 1 I , I I , I r , , I I , I II' 1 I I.' I 1 ' I I II II . I I I I . I . , I I r I , I , I , I I , I I I I 1 I ~ , I II BUilDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN I SIGNATURE . Address I PLUMBER I SIGNATURE Address I MECHANICAL I SIGNATURE . COMPANY REGISTERED COMPANY REGISTERED Address OTHER SIGNATURE Address Y/N FEE CURRENT LIcense # Y/N FEE CURRENT LIcense # Y IN FEE CURRENT LIcense # Y IN FEE CURRENT Y/N I I I I I I I I I I Y/N Y/N Y/N License # I ~,~/~ F~~~ I License # I Ct:..e Y/N I I sJ.r.rO..r 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 onsile, Construction Plans, Stormwater Plans wI Silt Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permil for subdlvlslons/large projects COMMERCIAL 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 wi Slit Fence Installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTy SURVEY required for all NEW construction. 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 Directions: 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..l1eeds ROW