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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />(Jv <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />rL fYl! 2e.. <br />Owner's Address 39 (p (}f 9 u !} yf Z <br />Fee Simple Titleholder Namel <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />g c; hoey <br />j3" /1J ~/r I} J tJ <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />9uI}vfz <br />fJf. I <br />B <br />D <br />D <br />5/iJg <br /> <br />()r- <br /> <br />SUBDIVISION <br /> <br />LOT # <br /> <br />PARCELlD#/ g.q - 2lP.- 2\ - 002-0 ~ e(XJC)C-t)o~'1 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />EJ <br /> <br />PROPOSED USE D <br /> <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I {O ^( Lv'" c re,. <br /> <br />BUILDING SIZE I SQ FOOTAGE I 2lR. I- ~ HEIGHT I <br />TTfTlTITTTTTTJ 11111111111111111111111111111' '11111'111111111111' II III '111111' 111111111' '11111111'11'1111"" 1111111111" 11'1111'" 1I111111 r' '11111 <br /> <br />ADD/AL T <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 />1$ ~L(56.C30 I <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 />11111111111I11111111111111111111111111111I1111111111111111I1111111111111111I111111111111111I111111111111111111111111111111111111111111111111111111 <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 />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y IN FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE , <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I (] / J- <br />SIGNATURE, L[::J <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />~ 5(!) ~ UJ,..{{FC- fc <br />I I N I FEE CURRENT I Y I N <br /> <br />I <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />..11...11...........11...111.1111..111.....11................11........11.........11,..'11..11.......11111111.......111......1111111.....11.111111. <br />Directions: . <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 NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />