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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />rQA-O IJ-/Oll-UU41
<br />
<br />Date Received
<br />
<br />
<br />Owner phone Number
<br />Owner Phone Number I
<br />
<br />Owner phone Number I
<br />
<br />Owner's Name
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I 3&)5 lo[o\fe 5+
<br />I fv70 iec,-f, c {)a kj
<br />J
<br />
<br />LOT #
<br />
<br />I JLI'?
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />I
<br />
<br />B
<br />o
<br />o
<br />DESCRIPTION OF WORK I POi' ,1 rn~1 5 ef --L{p
<br />
<br />BlIlLDING SIZE I Lj / X ;' Z ISQ FOOTAGE I Lfq 2
<br />
<br />111..'11.11'....'..,....".11......"..........,..111.11....'..11.1111...11..11.'1,.............11.11"..11.111.....11'.....111'11..1.111111111111
<br />
<br />tZt
<br />D
<br />D
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCELID#I '24~2Jor 21-COsD --(XyX)Q -iZ 10
<br />(OBTAINED FROM PROPERTY TAX NOTICE) l'-t Z 0
<br />AD DIAL T D SIGN D MOVE D DEMOLISH
<br />REPAIR
<br />COMM D
<br />FRAME D
<br />
<br />OTHER ~ Cma"-f./.j
<br />STEEL OTHER I
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />HEIGHT I
<br />
<br />D BUILDING 1$ /5dOO co
<br />D ELECTRICAL 1$ 500.00
<br />D PLUMBING 1$ 2,)0. cO
<br />D MECHANICAL 1$ /(J)o. CD 0
<br />D GAS D ROOFING
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />.Jf t--JJUl6.. 6c;.e:. \c ~~
<br />0Dc; - ~'c9.
<br />1--- ~ 2Yo \fl,,/
<br />
<br />, I , I I I , , I , I , , , I I I , , , , . I It' I . . , , I . , , I I r I I I , , . . I . I I I , I I I t I , , . I I , , . , I , . I' , , , , I I I , r 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
<br />
<br />o
<br />I
<br />
<br />SPECIAL TV D
<br />
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />BUILDER ~
<br />SIGNATURE .
<br />
<br />Add.... J3 / V.
<br />
<br />ELECTRICIAN~.. .~ -....
<br />SIGNATURE ==============--~
<br />
<br />Address
<br />
<br />
<br />~~::=:. ~ >
<br />
<br />
<br />MECHANICA. L~. .
<br />SIGNATURE ~_~__~..
<br />.....
<br />
<br />Address
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED FEE CURRENT
<br /> License #
<br />COMPANY
<br />REGISTERED
<br /> License #
<br />COMPANY
<br />REGISTERED
<br /> LIcense #
<br />COMPANY
<br />REGISTERED YI N FEE CURRENT YIN
<br />
<br />
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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