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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received II d'
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<br />OWner's Name tw ~ d~J ~ I (
<br />Owner'sAddress 17 ~b ~()lIi!5j,~. ()~ ~~rkj I
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<br />Fee Simple Titleholder Namel (fl' (e;r aIO"; cI I
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />Fe. Simple Tode..'d., Eiif~ GtJl E/(/t;? -Z~~ (hllfS, fi,. 33~Z tUlI (f If 14 r!f!\
<br />JOB ADDRESS
<br />SUBDIVISION I 1 PARcELlD#1
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED 8 NEW CONSTR B ADD/ALT 0 SIGN D MOVE 0 DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE 0 SFR D COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME D STEEL D OTHER I
<br /> ;-Iech,(~ ' (f;
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<br />~~:';?,I~~,~:~~"".',??, ~,;,i." """"',, I' ,~~ ~?~~~~~"""""""" I""";" " ~,~:~~~, ,I, I """""""""" I""""""""""",
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<br />0 BUILDING 1$ 201 ~ I VALUATION OF TOTAL CONSTRUCTION
<br />0 ELECTRICAL 1$ 1-~P I AMP SERVICE D PROGRESS ENERGY c===J W,R.E.C,
<br /> ~~J
<br /> ,
<br />0 PLUMBING 1$ S' I ~6t> I
<br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION 2, ~~~
<br />0 GAS D ROOFING 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I DYES c===J
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<br />BUILDER
<br />SIGNATURE
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<br />
<br />COMPANY
<br />REGISTERED
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<br />
<br />
<br />tddress
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<br />\~CTRICIAN
<br />SIGNATURE
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<br />s cOt- PC FL 335IPIo
<br />~& ~
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br /> License #
<br /> FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
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<br />, jddress
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<br />~MBER
<br />SIGNATURE
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<br />~~[J
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Di~~~ti~~~':' , , , , , , . . , , , . , , , , . , , , , . . , , , . . . , , , , , . . , , . . , , , , . . , , , . . , , , . . , , , . . , , , , . . . , , , , . . , , , . . , , , , . , . , , , , , , , , . . . . , , . , , , , , , . . , , , , , , , , , , , , , , , , , , , , , , , , ,
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<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)
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<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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