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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />..."....1 <br /> <br />Owner's Name <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />Fee Simph! Titleholder Address I :5a/l<e. <br />I s afr'l e. <br />I <br /> <br />a.s <br /> <br />a. hc;\J€- <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCEL ID#I <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />~ <br />D <br />~ <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />B <br /> <br />PROPOSED USE D <br /> <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I R... e - rooT <br /> <br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I <br />TTflTfnTfTIIIIIII' 1111111111' 1111111111111" 1111' 111111111111111111' 11111111111111111111111111'1111111'111111"" 11111111"" 1'111' 11'1111111" II <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER I re-fCOr <br />STEEL D OTHER I <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE <br /> <br />D <br /> <br />DEMOLISH <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE: . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE: <br /> <br />I <br /> <br />lLfOD <br />1$ <br />1$ <br />1$ <br /> <br />D GAS C8[ ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATiONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111111I11111111111I1111111111I1111111111111111111111111111111111111111111111111111111111111I11111111111111111111111 <br /> <br />:~~~~~RE I. ~ ;C;:~cd1_ I ~~:: IYkie,~. Y/N I <br /> <br /> <br />Address . License # I <br /> <br /> <br />ELECTRICIAN I I COMPANY I <br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address I License # I <br /> <br /> <br />PLUMBER I COMPANY I <br />SIGNATURE: . REGISTERED Y / N FEE CURRENT Y / N <br /> <br />I License # I <br /> <br />I <br />I <br />I <br />I <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WR.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />DI~~~ii~~~': . 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 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 . 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 . . . I <br /> <br />Fill out application completely. <br />Owner 8, 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 Applic <br />Reroofs Sewers Service Upgrades <br /> <br />Driveways-Not over Counter if on public roadways.. <br /> <br />