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813-.780-0020 Date Received Owner's Name Owner's Address Fee Simple Titleholder Name Fee Simple Titleholder Address JOB ADDRESS SUBDIVISION WORK PROPOSED PROPOSED USE TYPE OF CONSTRUCTION DESCRIPTION OF WORK City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Owner Phone Number : \ ~ Owner Phone Number I Owner Phone Number I PARCEL ID# 1)6YtJ I a - '(OT# 00/0 ~ e QX>oO SIGN ROM PROPERTY TAX NOTICE) D MOVE 0 DEMOLISH @ o o ADD/ALT REPAIR COMM FRAME o o OTHER o STEEL D J r(,vB~'1(A~ (OOO 14/ :l.T&t ':j;:;,1f.t,l3ltXJO /f I HEIG~T I ' I OTHER I BUILDING SIZE I 1111"111PIIIIIII,III",I"IIII"IIIIII"III"III,I'1111111111'111"11'1111"11"1111'111111'"11"111""'"111"11"111111"1'1'1111'1'11111111'1"111'11111 1$ I 1$ I 1$ I 01 L/-/5~, 'J~ I D GAS D ROOFING 0 SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 1II11111111I111111II11111I11111111II111111111I1I11111111111 11111 11111 11111 III ill 11111 I1111 11111 11111 11111 ill 111111I1111111111I1111111111111I111111 I I I I I I : I I D BUILDING D ELECTRICAL D PI_UMBING ~ MECHANICAL BUIl.DER SIGNATURE Address ELECTRICIAN SIGNATURE NEW CONSTR INSTALL SFR BLOCK VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY AMP SERVICE D D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION Address COMPANY REGISTERED PLUMBER SIGNATURE COMPANY REGISTERED Address MECHANICAL SIGNATURE Address OTHER SIGNATURE COMPANY REGISTERED Address License # 111111111111111111111111111111'lllllllilllllllllllilll'111111111111111111illllllllllllllllllllllllllllllllll1111'lllllllllllllllllllllllillllll'il 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 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. COMMERCIAL SIGN PERMIT Y/N FEE CURRENT Y/N License # Y I N Y/N FEE CURRENT License # Y/N Y/N FEE CURRENT License # I I ~~~Cu~0<l"N I ~ License # I CI'tC- () L{ 2-- 1 z-- l Y I N Y/N FEE CURRENT 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 . 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 A/C Fences (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways._needs ROW