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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Fee Simple Titleholder Address I I 39-1Lf 7tJurA!f(;,JC- Dr I E/l1e//-J/1J IY f. El NEW CONSTR INSTALL PROPOSED USE D SFR 0 TYPE OF CONSTRUCTION D BLOCK 0 I DESCRIPTION OF WORK I 5I/f 8 oJ- /0 0 Iv S BUILDING SIZE I I ..11...........11.............11......................11......111...............11...11..11.11...........................11...11111....,11......11 Owner's Name ~ lit .3SYt! j()urfVltf 5'1J#Je Owner's Address Fee Simple Titleholder Nam~ Owner Phone Number Owner Phone Number I Owner Phone Number I JOB ADDRESS LOT # I I ! I~~(o I I SUBDIVISION I B PARCEL ID#I WORK PROPOSED ADD/AL T REPAIR COMM FRAME D D D sa FOOTAGE I (OBTAINED FROM PROPERTY TAX NOTICE) SIGN 0 MOVE D DEMOLISH OTHER I STEEL 0 OTHER I HEIGHT I 0 BUILDING 1$ ;t'"\ 601 C5D I VALUATION OF TOTAL CONSTRUCTION 0 ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY D W.R.E.C. 0 PLUMBING 1$ I 0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION 0 GAS D ROOFING 0 SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 111.111..........11........11....................1111.111.....111..111..11.11........1111...111...1111......IIp.I.....I........................... BUILDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN SIGNATURE COMPANY REGISTERED Address PLUMBER SIGNATURE COMPANY REGISTERED Address MECHANICAL SIGNATURE COMPANY REGISTERED Address OTHER SIGNATURE Address Y/N FEE CURRENT License # Y/N FEE CURRENT License # Y / N FEE CURRENT License # Y/N FEE CURRENT Y/N Y/N Y/N Y/N License # I a!~"( "f;,:;::d'iYIN License # III1III1I111 r 1111111111111111 t r" 111111111111111111111'1' I 1'11111" I 1111111' 1111' It' 1111' I" 1111111111" I" I 111111 r I I 11111111 r, 111111111111111' III Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. RESIDENTIAL COMMERCIAL SIGN PERMIT 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 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 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 NC Driveways Fences (Plot/Survey/Footage)