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813-780-0020 City of Zephyrhills Permit Application Building Department -# I~ 6tX-813-780-0021 Date Received ___Owner's Name -:-""",Owner's Address Fee Simple Titleholder Namel Fee Simple Titleholder Address I 38'J 33 --PROPOSED USE - TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK 7/71 /lpE I ~ ADD/AL T REPAIR COMM ~ FRAME D L-t& '!fAtv') fb)t:: /1IErck- SQ FOOTAGE I I -JOB ADDRESS LOT # PARCEL ID#/ SUBDIVISION (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH I ."'11....1'..."1.........11.'111'..........'1..111...'11..111..111....111...........11,....11......11.........11111,......'111...'.............1111. E3 D D I 7JAJ6 tE I D D OTHER STEEL I D ~WORK PROPOSED OTHER I 5 rt/(!(.o -DESCRIPTION OF WORK BUILDING SIZE HEIGHT -D BUILDING :: : VALUATION OF TOTAL CONSTRUCTION -cJ ELECTRICAL ~. . #. AMP SERVICE D PROGRESS ENERGY D W.R.E.C. Jt) - 50 .0'.1 .. ". D PLUMBING 1$ 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 I , It. , . , I . . r , I I . . I . I I I . I I P , I I I . , I I . . . I , , I I I . I I I I . . , I I f 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 t I , . . I . . . , I I I I I . I . . I . . . . , I I . . . I I I I I BUILDER I SIGNATURE Address i ~ECTRICIAN SIGNATURE . Address I PLUMBER I SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Y/N ~ License # COMPANYI REGISTERED ~~CURRENT License # I Y/N COMPANY REGISTERED Y I N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Y/N Address License # OTHER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N III1III111II111 11111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 Address License # 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) 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 SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. 11I11111II1II111I11111I1I111I111III1111I111111III1111111111I1111I1I111111II1111III111II111111II11111IIII111111111111I111I111111111111111111111111I 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 (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW