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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 1{~~1b 1---( q-o '7 Date Received :::>/---'/IO,-J --.::r- 'I #- f.( tl' .f 5cV.t~~c../t' I ~~f A-+ I B o o ,- ()r 2t'""'1.. /V J" {/s Owner's Name \l,;f Owner's Address Fee Simple Titleholder Namel Fee Simple Titleholder Address ILI'r~, I --= 0\ ':~ ~ +o"}'~ I 0 "- +tel Lft \-.., + lA n. ~ PARCELlD#1 JOB ADDRESS SUBDIVISION WORK PROPOSED 0--'/ NEW CONSTR D INSTALL o SFR o BLOCK AOD/ALT REPAIR COMM FRAME PROPOSED USE TYPE OF CONSTRUCTION DESCRIPTION OF WORK 'J:,,,s tK'\ LI rJ'h,j 7C f<\.h, It (/EdT/lc,'I- Owner Phone Number Owner Phone Number I Owner Phone Number I :S DJ 1-1- ,40' I.G LOT # o o o (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE 0 DEMOLISH I D OTHER STEEL OTHER I (,,:: f <: l, It () J :)f/L v, cL r~..... r ... BUILDING SIZE I I sa FOOTAGE I I HEIGHT I TTTTTTTfTT"TTTlr, III t II" III' II" 11'11111'11111'111 I 1111' III' IIIIIII I III r 11111111111' 11111" 1111'11111111 I 111'111' r II' III1IIIIII r, 11111111111'1111 1$ I D ELECTRICAL I$:? 000 0 c) I D PLUMBING 1$ I D MECHANICAL 1$ I D GAS 0 ROOFING 0 SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 1I11111II111111111111111II111111111II1111111111I11111111111I111111111111111I111111111III11I11111111111I111111111111I111111111II1111II1111I111111I1 D BUILDING AMP SERVICE VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY 0' D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION ~~ ~ License # 11111111I111111111I111111111II111111111I111111111II111111I1111111111111I111111111111111I11111111I111111111111111111111111111111111 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. 1I11111111111111111111111111111111111111I11111111111111111111111111111111111111111111I111111111111111II11111111111111111I11111111111111111111I11I1 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 BUILDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN SIGNATURE Address PLUMBER SIGNATURE COMPANY REGISTERED Address MECHANICAL SIGNATURE COMPANY REGISTERED Address OTHER SIGNATURE COMPANY REGISTERED Address 111111111111111 RESIDENTIAL COMMERCIAL SIGN PERMIT YI N Y/N FEE CURRENT License # ~ ~v &C-J YI N FEE CURRENT I Y/N I License # I cc.., l3 00 24 8 l Y I N Y/N FEE CURRENT License # Y/N Y/N FEE CURRENT License # YI N Y/N FEE CURRENT Driveways-Not over Counter if on public roadways..needs ROW Fences (Plot/Survey/Footage)