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City of Zephyrhills Permit Application Fax-813-780-0021 Building Department '( ! l -tt f6 \'"3 ~ l20 ,.. ~ () 0 3> ~ l' ~ I Phone Contact for Permitting ~ l ~ 71 - .3 2 80 Owner Phone Number I ~ - 7 r z..t;; "/7 2"t<I"''''f~~on. Numb.. I /-7~? >05//72- ] Owner Phone Number I 813-780-0020 l'ILf-oB Owner's Name ~ ole /14 /tlVo/L Owner's Address I h 1 0 I 7)/fl ~ !h"1V Fee Simple Titleholder Namel Date Received JOB ADDRESS Fee Simple Titleholder Address I 6 7 () /l/1/71j ((~ Zdfly~ ~ ' 3~S-f'2..- I PARCEL 10#1 D NEW CONSTR [==:J ADD/AL T D D INSTALL CJ REPAIR PROPOSED USE D SFR D COMM D OTHER TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D DESCRIPTION OF WORK 12,uS~a.v ~ {lJ/J1;11t<1U1AC, ~ ~.fCr ~tlP 1D? ~ I SQ FOOTAGE I I HEIGHT I ' I LOT # SUBDIVISION (OST AINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH WORK PROPOSED OTHER I BUILDING SIZE I . '. I . . I I I , I . II I . . . I I , I P I I . . . I I I I . , pi' , , 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 D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ Sa ~tkA I/' AMP SERVICE D PROGRESS ENERGY D D PLUMBING ::~ ~9sz,~ : / VALUATION 0; ~ECHANICAL INSTAllATION Q D MECHANICAL D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES BUILDER SIGNATURE Ad ress JI€~ti S, /~LECTRICIA ~ , Address Address I MECHANICAL SIGNATURE . Address I OTHER I SIGNATURE Address I I o V1f.-..z~ 1{263 )/, ~~-;~r:;" 336/Y' I I PLUMBER SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N COMPANY REGISTERED License # I 11ty%o/=:~ 'Y/N I License # I t!!,tJ,oS-"yz- COMPANY REGISTERED Y/ N FEE CURRENT Y/N License # I1111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 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 l~~ (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary'j::aGilitiesi& 1 dUmpstl;lL Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT AttaGh (2<)':~ets at Engineered Plans. ' ....PROPERTY'SURVEY required for all NEW construction, 111I111111111111I1111I1111II111II111111I11111I11111111I111111111111I111111111111II111I11111111I1111111I1I11111111II11111111111I11I1I111111I111I11I Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (Ale 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