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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 f:f 50~" Date Received Owner's Name Mfr~ Owner's Address 137..5 y (7 (j511[J'f!fl! jJ;t Fee Simple Titleholder Namel JOB ADDRESS Fee Simple Titleholder Address I 3 7}Y~ (j\flf!flll /)/. tJ(r) 6tltiJO/) LOT # SUBDIVISION PARCEL 10#1 WORK PROPOSED (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH PROPOSED USE TYPE OF CONSTRUCTION OTHER I DESCRIPTION OF WORK I I , . . . I I . . . I r ~ , . 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 r I I , . I I I , I . . . . . . . . . . . . . . . . . . . D BUILDING 1$ 6'7)-;;' D ELECTRICAL 1$ D PLUMBING 1$ D MECHANICAL 1$ D GAS ~ FINISHED FLOOR ELEVATIONS I SQ FOOTAGE I BUILDING SIZE VALUATION OF TOTAL CONSTRUCTION AMP SERVICE D PROGRESS ENERGY D W.R.E.C VALUATION OF MECHANICAL INSTALLATION ROOFING D I SPECIALTY D FLOOD ZONE AREA OTHER DYES DNO I I I I . I . , I I , . . . . I I I . . I , I I I , I I I , I . . . . I I I . P P I II I I . I . . . I , , I , I III1 I III I . . , I I , I I I , , r I I I I II , I I I 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 II , I II , , II BUILDER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N License # COMPANY REGISTERED I Y / N FEE CURRENT Y/N License # Address ELECTRICIAN SIGNATURE Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Address Y / N FEE CURRENT Y/N OTHER {("@flAW Cd.//!5 /1<! ~ r7 SIGNATURE Y / N FEE CURRENT Y / N Address License # I /c- c- 132. (, (t;t;; I1111I111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111I111111111111111111I11111111111111 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 w/ 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 on site, 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 SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. I111111111I1II111111I111111111111111111I11111II111111I11I11I1I111111111111111111I1I1111I11111111111II11111111111I1I1111111111I111I111111I111111111 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 AlC License # Fences (PloUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW