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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-7HU-UU~1 Date Received Owner's Name Owner's Address Fee Simple Titleholder Namel Owner Phone Number Owner Phone Number r~ g I 3) q Cf 1- t q 30 Owner Phone Number i Fee Simple Titleholder Address I 5~~O l 0 J.J\ S t 1 LOT # I J PARCELlD#\ tI-;<h -;;u - 0010 - I gt 00- Of JtZ) (OBTAINED FROM PROPERTY TAX NOnCE) 8 NEW CONSTR 0 ADD/ALl 0 SIGN 0 MOVE 0 DEMOLISH INSTALL [JLJ REPAIR PROPOSED USE 0 SFR 0 COMM 0 OTHER I . TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL 0 OTHER I ;~~;~; ~ [.".".~ i,,; ;;7~!. ~~~''''~ ,~t~~, L"".,,,,,,,,,,,,...I.,,,,,,,,,, "'.""",: 1$ I 1$ I 1$ I pO MECHANICAL 1$ 5l () 0, 00 I o GAS 0 ROOFING 0 SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO 111111111111111111111111111111111111111111111111111111111111111 ; 1111111111111111111111111111111111111111111111111111111111111111111111111111111111 JOB ADDRESS SUBDIVISION WORK PROPOSED BUILDING VALUATION OF TOTAL CONSTRUCTION o PROGRESS ENERGY o W.R.E.C. o o o ELECTRICAL AMP SERVICE PLUMBING VALUATION OF MECHANICAL INSTALLATION Address License # 111111111111111111111111111111111111111111111111111111111111111111111111111111111. 1111111111111111111111111111111111111111111111111111111111111111 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 wI Slit Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsionsllarge projects COMMERCIAL 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 wI Slit 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. BUILDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN SIGNATURE COMPANY REGISTERED Address PLUMBER SIGNATURE COMPANY REGISTERED Address OTHER SIGNATURE MECHANICAL SIGNATURE Address I ~;;l. B;;{ V S COMPANY REGISTERED Y/N FEE CURRENT Y/N I I I I I I I I I I License # Y/N FEE CURRENT Y/N License # Y/N FEE CURRENT Y/N License # ~;~I I A(~CU~NT~i I License # ICAC05gS15 Y/N FEE CURRENT Y/N DI~~~ti~~~': . .. . . . . . . . . . . . . . . . , .. . . . .. .. . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . .. , . . . . . . .. . . . .. .. . . . . . . . .. , .. , .. , .. .. . . . . . . . . . .. . , . . . .. . .. . .. . .. . .. . . . 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 NC Fences (PloUSurvey/Footage) Driveways-Not over Counter If on public roadways..needs ROW