|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 �
<br /> � Building Department
<br /> Date Received� �,. -- � phone Contact for Permitting - �(���
<br /> Owner' me � � � �. � Q i�1 , Owner Phone Number � �� � ��
<br /> Owner's Address ?j �`�• Owner Phone Number
<br /> �—
<br /> Fee Slmple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address I
<br /> JOB ADDRESS a � LOT# �
<br /> �
<br /> SUBDIVISIOM PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR� ADD/ALT 0 SIGN � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE � SFR � COMM �] OTHER
<br /> TYPE OF CONSTRUCTIOPI 0• BLOCK Q FRAME 0 STEEL �
<br /> DESCRIPTION OF WORK� ��/��..L��. �'� Q 1� � /�
<br /> BUILDItdG SIZE SQ FOOTAGE�� FIEIGHT
<br /> OBUILDING ' $ ��� �;z� VALUATION OF TOTAL CONSTRUCTION ���L"
<br /> �
<br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ ���,A��� �,��� �`�,I�
<br /> V��� �
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ��� {�
<br /> � - � !�'�� S-t<) ��duc
<br /> �GAS Q ROOFING � SPECIALTY � OTHER
<br /> �L � ` ep,•r s e�S�eP�
<br /> FINISHED FLOOR ELEVATIONS �q�FL ZONE AREA �YES 3 f7��� ��i.��
<br /> (J� e. , , ' �� $`C(.
<br /> r �13 �`
<br /> BUILDER `�f` nn. n � {� COMPANY �� ,�p �
<br /> SIGNATURE � 1��-C�-�-fXR V�-00�-�1 REGISTERED Y/ N FEE C���'UR�� Y/N
<br /> Address License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATI-IRE . kEGI$T�RED Y/ - FEE CURRE� Y/N -
<br /> Address' .. . , _ � • . Licen'se#' ' ' � • .
<br /> PLUMBER � . , COMPAWY ' , , >
<br /> SIGNATURE ; REGI$TE}�ED Y/. N. .FEE EURRE� Y/N
<br /> Address - � License.#
<br /> ' .. . � '>r ..t ...._-..._ �... ,
<br /> ' -------r-----.. :- —_:_..
<br /> MECHANICAL ! •---- �- _,_.�.�.,. _ • • --�60M�ANY = . °=- - : �. . ,. .. _ .....
<br /> �L���TU��--'��; ' � � REGIS7ERED Y/ N FEECURRE�� Y/N '
<br /> Add�ess. - �� " -_." __ --- ---._.--.; ., ----_ _:: .. - - --' _; ----- - - -- -.:_._ _..._
<br /> • • •-License#-� - •
<br /> OTF�ER:. � . � , ' •�OMPANY ,.. ,,.�u,_r�.•>.,,.:.,.., .: .
<br /> SIGNATURE' � REGISTERED ' � Y/�N � � FEE CURRE� Y/N
<br /> Addre�s _ , . . ;,Jn;,;v� � r���i;-,•� �License"# �
<br /> � .]i
<br /> RESIDEtdtIAL. Attach(2)PIot.Plans;.(2)�sets of Builcling Plans;(1)set of Energy Forms;R-O-W Permit for new constniction,
<br /> Minimurit ten(10)working days after submittal date. Required onsite,Construction Plans,.Stormwater Plans-w/Silt Fence installed,,
<br /> Sanitary Facllfties&1 dumpster;Site Work Permit for.suBdiVisionsAarge projects - -..-.- _ . .
<br /> �OMMERCIAL• Attach(3)complete sets of Building Plans plus a�Life.Safety Page;(1)set of Energy Forms.R-O-W Pemiit for new construction.
<br /> Minimum�ten(10)working.days'after submittal date. Required onsite,Const�Ction Plans,StbFmwater Flans w/Silt Fence installed,
<br /> ;= � ��• Sanitary Facilities�&.l dumpster.Site�Work PeRnit fbr�HtileW ptAjedtS'.,'AI!'ecirfiTi�eFc�f�l}�c�rSiY�tt3�i►i��riifr`�t�#i9�fi�tbht�li�M'ce�•�r-3-+>. '
<br /> 51GN PERMIT Attach(2)setS;of�Engineered PTans-:-� -.� �`- "` - - ' > �- - �- "• - _. �
<br /> • (,.�-<< 1. F�±i 1'�,{. -i;��l:�1"R%1+?"(CP�'
<br /> . ""PROPERl'Y SURVEY required for�all N�1 cods�ictib�. � -
<br /> .... ..__.-�---•------.�.._.. ! -
<br /> 7irections:� • , :.� ,. i.� ' � �,,,,�,�r,;���.,�. - . i .n�<C:�!����-.. ..,.r:,�f 1:1('�:- ,._ ' _ _ •.,, ': , -
<br /> Fill out application;complefel�:, � � � � ' � � - � " '
<br /> Owner&Contractor sign baGR.of:application,_nntarized ,
<br /> ': ,If over$2500,''�a Notfce'of Cdtnmencement is required. (A/C upgrades�over$7500) ` _ � �_ �
<br /> " AgenY(for the contractor)or Powerof�Attrnney(fbr th'e owner)would be someone with notarized letter.from owner authorizing same
<br /> n� " .... - ��� 1 l�/1-rlQ{`!l:f; N.i {.��P.,.�( �i. ild::�(R! I F :IL�r•1 . ._
<br /> �VER THE.COUN`I'�R PERfVIITTI�IG (Ffont of App�cation�nly) • • . -- . ., ,
<br /> Zeroofs if shingles• Sewers �- •-Service�l3pgrades'A/C � Fences(Plot/Survey/Footage} . ' '. . _ � � --
<br /> ' j !j �'C?Lr,.;r,,:� �:�--;" ° CF�-('.!�ti_.,.� �---�--- rsYH4.F� , .� -
<br /> Drlveways-Not over Counter if�on public roadways..needs ROW .. '"- "- . "
<br /> • � � ' , � , , , ,:,'" .. , .
<br /> .,�.... _� .., � ., � '.; �. �•-� ,.;�... . . :.t._ ._r,r�_-�. .w;.�.�, . .. t. .r�<+�.�.er,.� .,,. : . . .. , i --
<br /> . . , , �f
<br /> �.. • �Y� -� .. _ .� ....�, : � ..� ., J...-•;•�.':1�. .� I . :_._.'. �.... '_"_ ". . .� " I
<br /> I
<br /> . .. �.. ' 1 ..- . 1 - . ._.' '-` . � . " - . .. �
<br />
|