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<br />8"13-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />{
<br />I L, iliD DO--l VI ru...
<br />I
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I /.:::; ~ tJ4 LL
<br />
<br />BUILDING SIZE SQ FOOTAGE I HEIGHT I
<br />TIII'I'III'IIIIIIIIII'II'I'II"IIIIIIIIII'IIIIIIIIIIIII"111111"'1'11"'111111""'11'11111111111'111111"'1'11"11111111111111111"'1""1111111
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />3 ~). '-t ~ f30 u- ~.J I 12J-.
<br />I ~:;J '"'I (p-.)..l- 001 0- OJ..) 00 .- bOlO
<br />PARCEL ID# d-
<br />
<br />B
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />D
<br />D
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />"
<br />
<br />1$ I
<br />700,C5D
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111I1111111111111111111111I111111111111111111111111111111111111111111I111111111111I1111I1111II111111111111111111I111111111111111111111111111111111
<br />
<br />I 0<=- I 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 />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />I~z~
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />& ~Y..2-2-f
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />License #
<br />
<br />I {"be
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />License #
<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~~~tj~~~': ' , . . , , , , , . , , , , , , . . , , , . . , , , . . , . , , . . . . , , , . . , . , . . , . , . . , , , . . , , , . . . . , , , , . . , , , . . , , . . . , , , . . . . , , , , . . . . . , , . , , , . . , . . , , , , , . , . , . . . . . , . . . . . , . , . , . , , .
<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 (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadwaysuneeds ROW
<br />
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