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<br />-t ' <br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />8'13-780-0020 <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />1t;Jf;Jr Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />WORK PROPOSED <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 3'l.3Lth Corn WiLll <br />I WMff Vl/Dcd,. I <br /> <br /> <br />o NEW CONSTR c=J <br />D INSTALL CJ <br /> <br />PROPOSED USE D SFR CJ <br /> <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK I ~ - ISU i- <br /> <br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I <br />1111'11111'1"11111""111111111111111111111'11"111'1'1111111111111111111111111111111111111111111111111111111111111'1111111111111111111111111'111 <br /> <br />Dr' I LOT # I <br />PARCEL ID#I'O -:J./p - ;),1- 01 aO - 00000- 050() <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN D MOVE D <br /> <br />D <br />D <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />1$ I <br />1$ 1 <br />1$ I <br />1$ 5tJOO l 00 1 <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111'111111111111111111111111111111111111111111111111111111111111111111111I111111111I111111111111111111111 <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />~ MECHANICAL <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />WR.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />~I~/ Alc Co <br />I ~ ~ N I FEE CURRENT I Y I N I <br />License # I G AGO 5 g 57.5 <br /> <br />Address <br /> <br />MECHANICAL ! <br />SIGNATURE . <br /> <br />Address <br /> <br />OTHER I <br />SIGNATURE <br /> <br />I <br /> <br />~ <br /> <br />~I <br />I <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~~~ti~~~': 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 & 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 A/C Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />