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<br />City of Zephyrhills Permit Application Fax-813-780-0021
<br />Building Department s\ ~ C{ '3 i - 5-D '7 7 rnu....cJt""""l
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<br />Fee Simple Titleholder Namel -rN"if .".,lm .i~'V;
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<br />Owner Phone Number ......:>..,;> OJ-
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />o NEW CONSTR 0 ADD/All 0
<br />D INSTALL D REPAIR
<br />PROPOSED USE 0 SFR CJ COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK CJ FRAME 0 STEEL 0 OTHER I
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<br />DESCRIPTION OF WORK I :r.....tTtr"",\ PfZAMiN~:' 1)"1 W9'J(~' ,SrnO\U2.- lX.tk
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<br />BUilDING SIZE I I SQ FOOTAGE Ii.., ~ --0 I HEIGHT I I
<br />11111'1'11'1'11'111"111111'1'1'111111111'11'111111111111111111111'111"1'1111111'1'11:'1111111111111'1111'1'1'11'111'1'1111'1'1111111111111111'11
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<br />.z-~ - "i - ,,;)jrJ -0' 5-00- bt') Ie 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
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<br />lOT #
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<br />! ~7- { "7
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<br />JOB ADDRESS
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<br />6~
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<br />SUBDIVISION
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<br />DEMOLISH
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<br />WORK PROPOSED
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<br />GAS
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<br />1$
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<br />1$
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<br />1$
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<br />1$ 5':;t. 0 (). (rtl
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />BUILDING
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<br />...... ELECTRICAL
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<br />AMP SERVICE
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<br />PROGRESS ENERGY D.
<br />R · 10e /o"l'~c:O
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<br />6111101~ 8uu-\-\ ~
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />CJ
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<br />W.R.E.C,
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<br />..... PLUMBING
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<br />.... MECHANICAL
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<br />ROOFING
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<br />SPECIALTY 0
<br />FLOOD ZONE AREA
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<br />OTHER
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<br />FINISHED FLOOR ELEVATIONS
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<br />DYES
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<br />DNO
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<br />COMPANY I
<br />REGISTERED I Y / N
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<br />I 1'19-1-
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<br />COMPANY I . .' .
<br />REGISTERED ULtL...!
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<br />JBUllDER
<br />SIGNATURE
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<br />FEE CURRENT
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<br />Y/N
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<br />License #
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<br />Address ~,.t,. <. (., c ~ N ~ o--.v..
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<br />Address I . .
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<br />~ A>>lUMBER I J\
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<br />Address {p () t.
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<br />I Y/N
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<br />License # C.
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<br />I Y/ N I FEECURR~T I Y/N I
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<br />""'= CURRENT
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<br />COMPANY
<br />REGISTERED
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<br />Address
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<br />
<br />COMPANY
<br />REGISTERED
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<br />,J.~ECHANICAl
<br />0/ SIGNATURE
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<br />OTHER
<br />SIGNATURE
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Dl~~~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)
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<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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