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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner Phone Number Owner Phone Number I Owner Phone Number I I I I I 1 Owner's Name Owner's Address Fee Simple Titleholder Namel st!J fJ~flve Fee Simple Titleholder Address I JOB ADDRESS 138'5;), " 5th Ave(lve.. SUBDIVISION I I WORK PROPOSED El NEW CONSTR ~ INSTALL PROPOSED USE D SFR D TYPE OF CONSTRUCTION D BLOCK D DESCRIPTION OF WORK I Bui I d (lew 6+oreft()('l+ LOT # PARCELlD#1 \ \ -'2.4>- 'l\-OO\O - \ 5'~60 -- Ob"1o (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D D D D FQ~e ",o\e DEMOLISH ADD/AL T REPAIR COMM FRAME OTHER STEEL I D OTHER I BUILDING SIZE SQ FOOTAGE I HEIGHT I ~lTTTn 111111111111111111111' 1111111111111111111111111111111111' 1'11111111111' '11111111' 11111111111111111' 111111111' 1111111111111111111" 111I ~ BUILDING 1$ 30,000. ~ D ELECTRICAL 1$ N/A AMP SERVICE D PROGRESS ENERGY O~ raY' D PLUMBING 1$ "'IA ~~ :!cf2; rJ1C/l5 D MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION PW& ~~ NIP, ~~ . D GAS D ROOFING D SPECIALTY D OTHER ~/m - '11t~7~ w~ FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA D:~~ i'.. I S?N~ , ,. ,~~~ ~~ ' n~ " 1I11111111I111111111111111111111111111111111111111111I1111II111I11111I11111111111II111111I11111I111111111111IIIIIIIIIIIIIIIIIIII~IIIIIIIIIIIIIIIII BUILDER I /J11- / / /: J.J .// J I COMPANY SIGNATURE /I~ 4-"" ~ REGISTERED FEE CURRENT Address I/'IYI E. CQf) Rd. lA./(el~I'IJ I FI 31fol~ License # I CBcoG>OI (,5" I ELECTRICIAN I I COMPANY I SIGNATURE REGISTERED Y I N FEE CURRENT Y I N Address I License # I PLUMBER I COMPANY I SIGNATURE . REGISTERED Y I N FEE CURRENT Y I N Address I License # I MECHANICAL I COMPANY I SIGNATURE REGISTERED Y I N FEE CURRENT Y I N Address I License # I I ~~HN",."ruRE~ t ~~~';.'::'~ ~Wr~~~l ~ Address . .'. ~~\ \.0.:\1'. ~ l ~L.Xk License # I I, 11111111111111111111111111111111111111111111111111111I1111I1111I11111I111111111111I11111111111111111111111111111111I1I1111111111111111111111111111 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 subdivisions/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 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 SIGN PERMIT Attach (2) sets of Engineered Plans. '***PROPERTY SURVEY required for all NEW construction. VALUATION OF TOTAL CONSTRUCTION o WR.E.C. Di~~~ii~~~': . . 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 AlC Fences (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW