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813- 780 -0020 City of Zephyrhills Permit Application ir (� Fax -813- 780 -0021 Building Department 5)4 7,YJ Date Received, id_r -0Ii Phone Contact for Permitting -- Owner's Name, 011A 1 3 & 4,13( ' A4 DM; e 1 v L `e... Owner Phone Number e/3--s yU -75 Owner's Address 37) 1.,41ga // ifM a . , Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address JOB ADDRESS Ple q5 /io/E- *3 "7 (p 0 3 bit-, '"Q /1-a44- ryi 0 k Dn • LOT # ,7 SUBDIVISION 04 14 141 PARCEL ID# ` Z 5-2 0 (a 0 l 00 M -- b Z l o (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR l`/ ADD /ALT n SIGN h MOVE 1 I DEMOLISH INSTALL NIN REPAIR PROPOSED USE lej SFR 1 I COMM I OTHER 1 I TYPE OF CONSTRUCTION I I BLOCK FRAME 1 I STEEL 1 1 OTHER 1 I DESCRIPTION OF WORK A00 eV 69oC1.( g) /lilt of ,-MIST 1 2. c ( j o BUILDING SIZE SQ FOOTAGE J2X/ 6 HEIGHT ) S / Er' BUILDING $ Z 5-0° VALUATION OF TOTAL CONSTRUCTION ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY 1 1 W.R.E.C. 1 1 PLUMBING $ I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I I GAS 11 ROOFING 1 1 SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS ; FLOOD ZONE AREA 1 (YES I INO BUILDER / 7, ,, , 1\" COMPANY -- SIGNATURE / REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y / N Address ? License # 41111■ZAMIPMEr■ /WM. ELECTRICIAN / / , / COMPANY No SIGNATURE // REGISTERED 1 Y / N I FEE CURRENT 1 Y / N 1 Address I - License # I PLUMBER COMPANY SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT l Y/ N 1 Address License # MECHANICAL COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1 Address License # OTHER COMPANY SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y / N 1 Address License # 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 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 all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. * ** *PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (NC 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 (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW