|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />I/;;S~
<br />~.._.__/
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />I
<br />I
<br />
<br />
<br />Fee Simple Titleholder Address I I
<br />
<br />:l83~&<tl~lJci(jPfh'lr:n~!\.2 K- 31~ J LOT' I I
<br />. _ PARCELlD#I02-..2(,"'J.J-W1Q-Q;l.l/W-~oro I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />~ ADD/ALT D SIGN D MOVE D
<br />D REPAIR
<br />o COMM D
<br />o FRAME D
<br />
<br />W ()--( K.'
<br />
<br />
<br />Owner Phone Number
<br />
<br />Date Received
<br />
<br />o
<br />'1 'Owner ~Number m( ;)..,~
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I S ~\-G
<br />
<br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I
<br />111111111"'1111'1111111'1111"1111"'111111"'1111111"11111'1111111111"'111111111111111'11111111111111111I'IIIIIIIII"II"IIIIII"IIIIIIII'IITT
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />1$ I
<br />;;7. (50 I \500 .
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING 0 SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111II111111111111111111111111111111111I11111111I1111I1111111111111111111111111111111111111
<br />
<br />:~~~~RE ~~:~,::::~ 5?&'~f"~,~JloL-H7'.r~
<br />
<br />Address FLJ3S'lf ( License # C ~
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />WR.E.C,
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />
<br /> FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<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
<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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Di~~~ii~~~': ' , . . . , , , . . , , , . , , , , , , , , , . , , , . , , , , . . , , , , , , , , . . , . . . . , , . . , , , , . . , . , . . , . , . . . . . , , , . , , . , . . , , , , . . , , , , . . . , . . . , , , , , , , , , . . , , . . , , , , , , , , , , , , , . . , , , , . ,
<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 NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|