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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner's Address Fee Simple Titleholder Namel Owner Phone Number Owner Phone Number I Owner Phone Number I Owner's Name Fee Simple Titleholder Address I I 66S~ r0A-/I/ B/uv IZc;f}. )/ jl1i/l/f: ~~1 PARCEL ID#I D NEW CONSTR E1 D INSTALL PROPOSED USE D SFR 0 TYPE OF CONSTRUCTION D BLOCK /I1Plc72{!/~ BUILDING SIZE I I SQ FOOTAGE I I ., . . . I I I I . It' P . , 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 (Ga\i\~ ('~a!>O') 03.-2C:, -2/-:0010-0/600 (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D LOT # JOB ADDRESS SUBDIVISION WORK PROPOSED DEMOLISH OTHER I I I /OOG/rL DESCRIPTION OF WORK D BUILDING 1$ 1 VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY D W.R.E.C ~ PLUMBING 1$ IJ 7-00.- I / D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 1"11"1"""""111"""'1,'"""",,,,1'1111111'1"'11"1111111111111111111111'1"11"'111"11111"""..111.'1111""....,................,1 BUILDER SIGNATURE COMPANY REGISTERED YI N FEE CURRENT Y/N Address License # ELECTRICIAN I SIGNATURE . Add~ss ~ :~:A~~E - - ~a ~ I Address looog IN b/VE,6~u71; /rUe ;#0/ I MECHANICAL I I SIGNATURE . . Address I OTHER I SIGNATURE I COMPANY REGISTERED I Y I N FEE CURRENT Y/N COMPANY REGISTERED License # I I D/2Apv /)ocTo4f' / /IVL I Y I N I FEE CURRENT I Y I N I License # ItFC! ItfZ--:;-7oS- COMPANY REGISTERED YI N FEE CURRENT Y/N License # COMPANY REGISTERED Y/N FEE CURRENT Y/N Address 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 onsite, Construction Plans, Stormwater Plans wI Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects Attach (3) complete sets of Building Plans plus a Life Safety Page; (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. 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 A1C COMMERCIAL SIGN PERMIT Fences (Plot/Survey/Footage) Driveways-Not over Counter if on public roadwaYSuneeds ROW