|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />
<br />Date Received
<br />
<br />Owner's Name I
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I (05<;- c:::, l3-,(~~-u<.::D
<br />
<br />W;-ZV~/~ (fl/<S.
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D
<br />I (\ld.-
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />PARCEL ID#I D Y - '2<0 - L' - OOd-D. 00000 . 00 A~
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<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 />~,::; -4C/Y\.
<br />I HEIGHT I
<br />
<br />I
<br />D
<br />/
<br />
<br />.
<br />
<br />OTHER I
<br />
<br />C.ho../Y,-~ Ou.-
<br />SQ FOOTAGE I
<br />
<br />\3 ~o \
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />11"1111111'"111'111.1111111111111"1111111111'11111111'111'111'1'11'1111'11111111'111"1111"111111111'.1'1""'II"lllflll,I'IIIIII"'II"111111
<br />
<br />D BUILDING 1$ I
<br />o ELECTRICAL 1$ I
<br />o PLUMBING 1$ I
<br />
<br />~ MECHANICAL 1~2~()O, ~ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />1111II11I11I111II11I1I11111111111111I11111I1111111I1I11111I11111111I11I11111111111I11111II11111I11111111I11111111111II11I11I111I111I11111111111111
<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 />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br /> FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address !
<br />
<br />:~~~~:,-I~ ~~I
<br />
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />DI~~~ti~~~': . . . , , . . . . , . . . , , . . , , , . . , , . . . , , , . . . . . , , , . . . . . . . , . . . , . . . . . , . , . . . , . . . , , , . . . . . . . . . , , . . . . , . . . . . , , . . , . . . . . , , , , , , . . . . . , . , . . . . . . . . . . . . . . , . . . . . . .
<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) WDuld be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers'. Service Upgrades AJC Fences (Plol/Survey/Footage)
<br />
<br />Driveways-Not over Counter If on public roadways..needs ROW
<br />
|