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<br />8'13-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Date Received'
<br />
<br />
<br />
<br />Fax-813-780-0021
<br />
<br />.~''l 99'51
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />3g--6 /h -3IJO/2
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />/071,
<br />I
<br />B
<br />D
<br />D
<br />
<br />flve
<br />
<br />PARCELlD#II/- 2.. c, -2..1- OO!cJ-O 93r:Jo- 0/90
<br />(OBTAINED FROM PROPERTY TAX NOTICEI
<br />SIGN D MOVE D
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I f2-e r-lJO ~ Ie <5 ? t-J /4. "3 () ;;!<Cc. ,.- ~;1.-L h~! ~
<br />
<br />
<br />
<br />~~:~~I~~, ~:~~ III .111111111 f 11111111 1 11111 .111111 ~~ ,~~'~~~~,~ ,III,( ~ "~<:"'III'I ! 1111 ~~:~~~ 1.1, ' 111111 1 1,1,,,,,111,,1,,,,,111,11,1,,11,,,11,
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />D BUILDING 1$3~r<:..iO I
<br />D ELECTRICAL 1$ I
<br />D PLUMBING 1$ I
<br />D MECHANICAL ~ ROOFING I
<br />D GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E,C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />111111111I111111I11111111I111111111111111111111111111111111111111I1111111111111I111111111111I111II1111111111I111111111II11111111111111111111111111
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />DI~~~ti~~~': . . , , , , , . , , , , . I , , , , . . , I I . . , , , . , I . . , , , . . , , I . . I , . . . , , , . . , , I . . , , , I . . . . I I I . . I I I , . I I I , . . . . I . . , . . , . , , , , , , , . , , . , , . , , , , , , . . , . . , , , , , . , . . . . . . . . . . .
<br />
<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 Attorney (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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
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