HomeMy WebLinkAbout21-2596City of Zelphyrihills
5335 Eighth Street
Zephyrhills, FL 33542
BGR-002696-2021
Phone: (813) 780-0020
Fax: (813) 780-0021
Issue Date: 08/02/2021
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10-1m= 1�1=11=10611119511111!111 iilillill'i IMPRIMIS 1!11 1
AMM700 re'ri
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE
JN
PEJAIT Ol
TWOUT APPROVED INSPECTION
A
813-78020 City of Zephyrhills Permit Application Faxm813®780a0021
Building Department
�S�l�eiuiuur 1Mri�IM � 11M
�d
� ownerphone Number
--
Owner Phone" Number
Owner Phone Number
111 19
not
} 6UILDING
$
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VALUATION OF TOTALCONSTRUCTION
ELECTRICAL
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iv1F$;, F�UiC PROGRESS N
Y, .R, . <
v,...
MECHANI AL
$
VALUATION OF MECHANICAL INSTALLATION'`
GAS
ROOFING
SPECIALTY OTHER,,.
FINISHED FLOOR ELEVATIONS
FLOOD ZON AREA =YES NO
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COMPANY
REGISTERED Y P N FEE URREh Y I, N"• .,
. i u��k�1MIMwYfMIMIiMIfiiWM �II�MiM�1i�l
{ a +
Minimum ten i 1. i'.. ♦w.' `1I\:,"FI
Sanitary Facilities & I dumpster; Site Work Permit for di projects
.
COMMERCIAL Attach (2) complete sets% of Building %Plans plus a LifsZafety page; (1) set of Energy %Forms. R-O-W Permit for new constructiom
teriP »Installed
umpsterSite Work Permit '..♦projects.;ll +� at compliance
SIGN PERMIT Attach ai s :♦
Fill out application oompletely.
Owner i Contractor sign back of,application, notarized
if Over $2500, a Notice of Commencement is required. (AIC upgrades over $75 0)
ant (for the ntraotor} or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THECOUNTER PERMITTING (dopy,ofcontract,required)
Rer fs if shingles Sewers Ser'ic, Upgrades Ali 'Fences (Plots u eylFnntage)
Driveways -Not over Counter If on public; roadways..needs ROW
INSTR#2021162156OR 8K1 0406 PG 884 page 1 of 1
08/02/2021 11:44 AM Ropt: 2333950 Rec: 10.00 IDS: 0.00 IT: 0.00
Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller
Fla
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City
CO**CwftTSw#M*No.: �a?—S93(h
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Arnowd of BoW: s Tekn%one No.:
6. Lentler
Nam
Address CRY So"
Ler4eft Teloptxme No.,
7. penwo wift ft StMe of Flwft desbnaied by Ms owner upon whom noftes or odw documoft may be serwA n pmvklod by
Soobon ?13.13(1 XaX4 FWrWS SWAftx---
None
Address COY State
TeIelphone Mwiw of Dwouded Pown:
In addlOon to t*nw#, ft owro4Ed9$VO!*w Of
lo rwellve a copy of the UenWs Nofte as pvAded in Sec4on 7113.113(1!Xb� FWft ftUm.
Telephone Number of Penion or EntWi DeMonded by Owrw
Exorelon do* of Nafte of Convnencemerd (twe a xpilregon date may not be belbve Ilhe cornOebon of and &W pft"wt W Me
conkaW, but wS be one yew ftm too delle of r000rdng unlew a dfto d0v Is OPKOKII� — =
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IM
' State Of Florida, County Of Pasco
This is to certify that the foregoing is a
true and correct copy of the document
on file or of public record in this office.
€ J.
4,r,
i ness my hand � d official seal this
day of 2 I
4 �
< (Nikki Alvarez -Bowles, q., Clerk & Comptroller
" �
� Pasco County,,, rida
°'° By--- Deputy Clerk
City of Zephyrhills
5335 81h St
Ze,*,hvr,1,iIIs F
licensed under Chapter 468, Florida Statutes as a(n):
Contractores V-'Engineer— Architect— Building Inspector_
License No. —L -LO-L -L- 111-
On or about did personally inspect the:
Check: Roof Deck Nailing
—"Dry in Flashing and Drip edge
Check which was used: 30# felt— Peel and Stick tether (List) S A/ `-//-
At the following
address:
I --
Rased upon that examination, I have determined the installation was done according to the Hurricane
Mitigation Retrofit M nual (Based on Section 553.844, Florida Statutes).
4
Signature: 77,
STATE OF FLORIDA
INGRID ROSARIO
COUNTY OF PASCO
My COMMISSION # GG 987406
fore this day EXPIRES; May 12,2024
Sworn t )and s bscrib
4�W, Bonded Thru Nok" Public Underwitefs
BY:
N ry ublic State of Florida