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Fax- 813 -M - uun City of Zephyrhills Permit Application y, 0 5 o 81 780 0020 Building Department _( 7 • 1 _ Mg: ___ ............. MEM Phone Contact for Permitting __ _____ R eceived • ............ _:___••• -• Owner's Name S- 1—(C Owner Phone Number Owner Phone Number C Owner's Address ' Owner Phone Number Fee Simple Titleholder Name p Fee Sim le Titleholder Address LOT # • 3 Ff2 (Cl /J =1 JOB ADDRESS .04:70 . 0•/I • .0 � IIIIIII IIIIIIIIIIII PARCEL ID# L ( - 2 0 SUBDIVISION (OBTAINED FROM PROPERTY TAX NOTICE) D EMOLISH NEW CONSTR e ADD /ALT SIGN Q MOVE WORK PROPOSED e 0 INSTALL REPAIR PROPOSED USE ED SFR =i1 COMM FRAME Q STEEL [ �] OTHER � TYPE OF CONSTRUCTION Q BLOCK .mo o Sir v Gtr/ e- e DESCRIPTION OF WORK � HEIGHT BUILD SIZE 1=== SQ FOOTAGE ................................................................................................. ............................... • ..................................................................................................................................... BUILDING VALUATION OF TOTAL CONSTRUCTIO Q W.R.E.C. 1111M 11111111 AMP SERVICE D PROGRESS ENERGY ELECTRICAL PLUMBING 111.11111111111 VALUATION OF MECHANICAL INSTALLATION MECHANICAL ROOFING ED SPECIALTY Q OTHER GAS =I FLOOD ZONE AREA YES [_]NO FINISHED FLOOR ELEVATIONS COMPANY ® FEE CURRENT Y / N BUILDER REGISTERED _ SIGNATURE License # Address COMPANY ® Y!N ELECTRICIAN REGISTERED FEE CURRENT SIGNATURE License # Address 111111111111111111111111 COMPANY 1110/31 YIN SLUMBER REGISTERED FEE CURRENT SIGNATURE License # Address COMPANY MECHANI REGISTERED Y / N FEE CURRENT Y / N SIGNATURE License # Address _ Ut G CS ,�s t S"G✓ Y / N OTHER COMPANY Cross Q REGISTERED Y / N FEE CURRENT SIGNATURE C /55 76 License # C Address � RESIDENTIAL Attach m teno(0aworkiing Building date. Required onsite, Construction tr e Plans, Stormwater Plans w/ Silt Fence installed, Minimum ( ) I Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large lrgs P of Energy Forms. R O W Permit for new construction. COMMERCIAL Attach m complete sets of days Plans as a Life Safety Page; ( ) Minimum tac (tie days * Ste Work Permi fo alt new pr All commercial requir StOrmwater Plans meet compliance SIGN Sanitary Facilities & 1 dumpster. SIGN PERMIT Attach ROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. application, notarized Owner & Contractor sign back of app upgrades over $5000) If over $2500, a Notice of Commencement is required. (A/C ** 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 A/C Fences (Plot/Survey/Footage) Driveways -Not over Counter if on public roadways..needs ROW I I