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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Recefved
<br />
<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 />~ ~ Zer^'1 r h, 115 rl '335"Lf ~ I
<br />I
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />SA fY) /;-
<br />
<br />-
<br />
<br />JOB ADDRESS
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<br />LOT #
<br />
<br />I
<br />
<br />D NEW CONSTR DADO/All D
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR 0 COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I
<br />
<br />_DESCRIPTION OF WORK I (). P G-tod e. F: IE CT. ( (eu-::;\'; e <2.-1\-\ \'.. e- hc.rLu-......-.)
<br />
<br />BUILDING SIZE SQ FOOTAGE I I HEIGHT I I
<br />111"111111111'11111111"1111111111"1111111111111'1111111111111111111111111111111'1"1'11111111111111111111111111111111111111I1111II11I1111111111
<br />~D
<br />
<br />PARCEL ID# I
<br />
<br />SUBDIVISION
<br />
<br />(08T AINED FROM PROPERTY TAX NOTICE)
<br />
<br />SIGN D MOVE D
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<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />1$ I
<br />
<br />---,-, ELECTRICAL 1$' I
<br />'--.J . I 7 00. c)O .
<br />
<br />D PLUMBING 1$ 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 />I111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o
<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 />k~7/~
<br />
<br />~COMPANY
<br />REGISTERED
<br />
<br />I-JuMf
<br />I Y/ N
<br />
<br />(')I,V/\€r
<br />FEE CURRENT I Y / N
<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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N 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 />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
<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~~~ti~~~': . . . . , . . . , , , . . , , , , . . . . , . , . . . , . . . , , , . . , , . . . , , , . . . , , , , . . . . , , , , , . , . . , . . . , . , , . . . . , , , . , , . . . . . . . . . . . . , , . , . . , , . , , , , , . , . . . . . , , . , . . . . , . , , . . . . . . , ,
<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 roadways..needs ROW
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