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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received It,. \ l1 -0'7 Owner'sName Haum G. A~d Owner's Addr,ess 13'?l{'iS ~ Ave(\vt!- Fee Simple Titleholder Namel Owner Phone Number Owner Phone Number I Owner Phone Number I JOB ADDRESS Fee Simple Titleholder Address I 13~l{45 I S.!J Aveflte. LOT # PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK PARCELlD#1 \ \ -'?lD .1.\... (:j1)\O - 'S3c5/.) -- Ol)~ (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D I ~ ADD/ALT D ~ REPAIR D COMM D D FRAME D f\ew stor'- front ~cG\de BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I 1111 , till 11111 11111 11111 III 11111 11111 11111 11111 11111 II , 11111 III III II III II III II I I III ' 111111111111 ' I11111 ' '11111 ' , 111111 1111 ' , 1111 , 1I11111 ' III tllIlI ~ BUILDING 1$ 5;),/()(P. ~ I VALUATIONOFTO~ONSTRUCTION o ELECTRICAL 1$ N/A I AMP ;:;~Co:J..~ 6"'~ PROGRESS ENERGY D PLUMBING 1$ 11't(Ji'''-C '(\~~~ ~ NDC- ' Nt A c ~ 0.-vY' 6QAN"I it" ~ ;.)\ Q; ~ D MECHANICAL 1$ N/A I ~VALUATION OF MECHANICAL INSTALLATION PU\}<s &-+0 ~<:Jl..Q.& . pc"-r ~ c-/Iq /67 D GAS D ROOFING D SPECIALTY D OTHER qm - 11119 {()7 ~ FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO tJcit- ~ SUBDIVISION DESCRIPTION OF WORK B D D I Build DEMOLISH WORK PROPOSED OTHER STEEL I D OTHER I D W.R.E.C, BUILDER I AU -I J / ( ~J.I/ /J I SIGNATURE ~ ..M/. ~ . Address I/Lf"{1 E.G~ry Rd. LAkdcUld,FI 3380l , ELECTRICIAN I I SIGNATURE . Address I PLUMBER I SIGNATURE I COMPANY REGISTERED Address MECHANICAL I SIGNATURE Address I I I I I I I License # I I ~~':.':."TURE I~ ~ ~~~':.': ~FE~; 1\~~/~t II'II~'~~~~~::~ t:~;~~~ 11~~~lllfill ~~~~II }IIIIIIIIIIIIIIIIIII ~:~;~~~ ~III,I"IIIIIIIIII'IIIIIIIIIIIIIIIIII,I' 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. License # IcaCO(,OlbS COMPANY REGISTERED Y/N FEE CURRENT Y/N License # COMPANY REGISTERED Y/N FEE CURRENT Y/N License # COMPANY REGISTERED YI N FEE CURRENT Y/N COMMERCIAL SIGN PERMIT Di~~~ii~~~.: 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 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 NC Fences (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW