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Owner's Name t e Owner's Address I ;j 8 7 G ~ ~ IcJ1l!l,o (' I ~ t!.f e Fee Simple Titleholder Namel IYJ Ii! h lJe I /? Eft f.J IS Fee Simple Titleholder Address 138 7 ~;. L4, If) IlIJ C, ~ . I 3f676J.. r.-0/C!Al3 O//(. I Vi/IAje Gt<ove 813-780-0020 Date Received JOB ADDRESS SUBDIVISION City of Zephyrhills Permit Application Building Department Fax-813-780-0021 n\Alnar Phnna NumhAr Owner Phone Number I Owner Phone Number I Ze.pl, y I( h " ~ , ,c'l NEW CONSTR INSTALL SFR BLOCK 325'1 ~ I lOT # I 58 PARCElID# I Q;? - ~ 6 - ~ /.. ~o J D - Of) 000 -oSB' /) (OBTAINED FROM PROPERTY TAX NOTICE) SIGN 0 MOVE 0 I eg D D BI' , 1, e 1$ I 1$ I 1$ I 1$ I D GAS 0 ROOFING D SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 11111111111111111111111111111111111111111111'1111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111I111111111 WORK PROPOSED PROPOSED USE TYPE OF CONSTRUCTION D BUILDING D ELECTRICAL D PLUMBING D MECHANICAL o o DEMOLISH f?q lJae OTHER I I o cJ... S ~ A- /(7 VALUATION OF TOTAL CONSTRUCTION AMP SERVICE D WR.E.C, D PROGRESS ENERGY VALUATION OF MECHANICAL INSTALLATION ~~tf~ 3176;l. I/u {l1I9~ C/~.. BUILDER SIGNATURE Address Y/N I I I I I I I I I I f~f<; I tJ~t:~NT License # I COMPANY REGISTERED ELECTRICIAN SIGNATURE COMPANY REGISTERED Y/ N FEE CURRENT License # Y/ N FEE CURRENT License # Y / N FEE CURRENT License # Y/N FEE CURRENT Y/N Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N Address MECHANICAL SIGNATURE COMPANY REGISTERED Y/N Address OTHER SIGNATURE COMPANY REGISTERED Y/N License # 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111 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 w/ 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 w/ 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. Address 111111111111111 RESIDENTIAL 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 . . 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 (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW r" J ,tIE- ! , to'~ :c, .1"1'