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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />Owner's Name
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<br />Owner's Address I L.f 04 -< IC/-I d1 H (( -y I< 1>
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
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<br />Fee Simple Titleholder Address I
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<br />I L-/ {}4IS j fM~: f3?
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<br />,
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<br />JOB ADDRESS
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<br />CF-I,q-NC(-'j (<. D 2-C=Pl-ty FL I LOT # I
<br />3:3 5=4~
<br />PARCEL ID# II)) - 2L;; -72 - bOIO- t~L\.DO. O()OO
<br />(OBTAINED FROM PROPERTY TAX NOTICEI
<br />SIGN D MOVE D
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<br />SUBDIVISION
<br />
<br />I
<br />
<br />o NEW CONSTR E3 ADD/ALT D
<br />D INSTALL REPAIR
<br />D SFR D COMM D
<br />D BLOCK D FRAME D
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<br />:;:Uk/OR fiSjf/J ~t.jT tf\O'~
<br />
<br />I SQ FOOTAGE I ..,,;/ rs 0 I
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<br />WORK PROPOSED
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
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<br />DEMOLISH
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<br />OTHER I
<br />STEEL D
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<br />~\-1)&,~
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<br />HEIGHT I
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<br />OTHER I
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<br />A. 8"~ I /
<br />AL'OATION OF TOTAL CONSTRUCTION
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<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />I111111111I1I11111111111111111I111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111I11
<br />
<br />~~S'S" Caus7: :;:--~~ I
<br />Y I N I FEE CURRENT I Y I N I
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<br />License # I Cft/2S2./<7 I
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<br />H~~ e.{Cj~ Eled: I
<br />I YI N FEE CURRENT I Y/N I
<br />License # lEe..- C>cCJ.<5?CJ I
<br />Cp~T*, a+s.Te>.pT~Al
<br />I Y I N I FEE CURRENT I Y I N I
<br />License # I C-F c t:).5'& 7 MJ I
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<br />D BUILDING
<br />D ELECTRICAL
<br />0 PLUMBING
<br />0 MECHANICAL
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<br />AMP SERVICE
<br />
<br />D
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<br />o
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<br />W.R.E.C.
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<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
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<br />1/Jft6//f ~~~
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Y I N
<br />
<br />Y/N
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<br />FEE CURRENT
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<br />License #
<br />
<br />YI N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />Di~~~ti~~~': ' , , , . , . , . . , . , . , . , , , , , , , , . . . . , , . , , , . , , . . , . , . . . . , , . . . . . , , . , , , , , . . , , , , . . , . , , , . , , , . . , , '. . , , , , , . , , , . . . . . . . . , , , , , , . . , . . , , , , , , , , , , , , , , , , , , , , . , ,
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<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
<br />
<br />.. Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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