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<br />,-, <br />0'- <br /> <br />I ''-1 ':)~ b <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills perm~ <br />Building Department <br /> <br />orq <br />fku't!15 3 <br /> <br />Date Received <br /> <br /> <br />..~h.?n.~ Son\Sct f.o.! Pen:" !~.!~~.. . . r-I .. <br />"' 'L!lL. .,. ."_ l-nL I. .., ...ffllmrt '!I.kC.Uh.l..t!!~nll.m II mii,~. <br /> <br /> <br />Owner's Name <br /> <br />06-6(L ASSG~ <br />13.gIoY~ <br /> <br />u-...... <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name I <br /> <br />GcCl<"\ <Z~( <br />- <br /> <br />fCOO~ 3 Fax-813-780-0021 <br /> <br />Owner Phone Number <br /> <br />OWner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />I ~ R'104Li <br />~ILLA6t <br /> <br />JOB ADDRESS <br /> <br />6-r 0-'"1 f.R C <br />- <br /> <br />L.a..--€. <br /> <br />r <br />~ <br />D <br />D <br /> <br />LOT# <br /> <br />6- n:ovc- <br /> <br />PARCELID#I D'L- 1..{., - 2)- 001 c.. - 0 DD.x.)~Qjpo <br />(OBTAINED FROM PROPERTY TAX NOnCE) <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />BLOCK <br /> <br />AOD/ALT <br />REPAIR <br /> <br />COMM <br /> <br />FRAME <br /> <br />DESCRIPTION OF WORK <br /> <br />SIGN <br /> <br />D <br /> <br />DEMOLISH <br /> <br />MOVE D <br /> <br />OTHER I <br /> <br />I <br /> <br />Cf~r ~,J <br /> <br />ROOFING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />OTHER <br /> <br />W~,"-<""L..,-.......I"""" <br />~"."\.~ <br /> <br /> <br />SPECIAL TV 0 <br /> <br />LOOO ZONE AREA <br />~0 <br /> <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REG/STEREO <br /> <br />. <br />lp.il~!lImMll!~UI~~lm#lmi!I!lilml:lulmcl~iGU;!ii:lllU~~II~m!l:mU~IUlnm=OOIUm~mIWulmm~m~llljEi~,"IWJII;lg!i~!mJJmtilil~1 <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 />REGISTEREO <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER ,~d /7 _ <br />SIGNATURE ~~ <br /> <br />I <br /> <br />COMPANY <br />REG/STEREO <br /> <br />-:::, <br /> <br />COMPANY <br />REG/STEREO <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />tto ('Y] 'L D f ()o 'I <br />~ FEE CURRENT ~ <br /> <br />License # <br /> <br />YI N FEE CURRENT ~ <br /> License # <br />Y/N FEE CURRENT ~ <br /> License # <br />YI N FEE CURRENT ~ <br /> License # <br /> <br />tto,.,..,Cc <br />Y/N I <br /> <br />o ~ PO' <br />FEE CURRENT ~ <br />~c..c.. ) ~ 'L <0 L~ I <br /> <br />iii~;i:~ii~iill~mi:iUl!llmI:ljl:i~liilillim:"m~lm;IDil~mlil:illi:iiiii;:n:lllliliJl:"DillmlllmliUmlm~mllililjmllllmlli~I~UlRmfil:l:ljlr~mr.IJm:mllm~mUllHlilIBfiIIWllii:m1llllmlllll:IIUl.UIIWliiiiiliWmmliiimlimli:iim~ilft~ilm~miJilU:~lanmlil <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Com men cement is required. (A/C upgrades over $5000) <br /> <br />Agent (for the contrac~or) or Power of Attorney (for the o'Mler) would be someone INith notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers SelVice Upgrades AlC Fences (PlollSulVey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />