|
�
<br /> s�s-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> J � F (
<br /> ; • Buitding Deparkmen#
<br /> , ,,, r _
<br /> Date Received /
<br /> � I � Phone-Contac#far Pe�mttting —
<br /> Owner's Name Y�G(hL�1, (� Qwner Phane Namber O � "'� ��'� i b=
<br /> Owner's Address ��V..�. �� �1''��� Owner Phone Number 0 1 �' 0�b ����0�
<br /> Fee Stmple Tltleholder.Name � —� Owner Phone Number � �
<br /> I
<br /> Fee Simple Titleholder Address
<br /> JOBADDRESS ��D� ��� (��1��"�-� LOT# [�
<br /> �
<br /> SUBDIVfSION �� � PARCEL ID# 11 " G�6 — 2� ""' �C)�� "�((")(8Q " �1�� .
<br /> I (OBTAINED FROM PROPERTYTAX NOTtCE)
<br /> WORK PROPOSED , e NEW CQNSTR� ADD/ALT � SIGN Q Q DEMOLISH
<br /> 'INSTALL REPAIR I
<br /> PROPOSEd-t1SE Q 8FR a C{3MM ( OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK � F M� �t%� STEEL [�
<br /> DESCRIPTION OF WORK �O NS TQV G'� S N 1.:p W� S NI��V IC. ROQ 1=
<br /> BUILDING S1ZE ��.j�}( � �p� � SQ FOOTAGE 1 �-. � HEIGHT I�.��'�:�,(�,,,
<br /> ����'d�N�' $ j��a� VALUATION OF TOTAL CONSTRUCTION
<br /> ' J
<br /> QElEC7RtCA�. ���� AMP SERVlCE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ . . ��y�/J� ���.�+"�
<br /> � S���
<br /> QMECHANICAL $ VAlUAT10N OF MECNANICA�1NS3'ALlAT10N �'
<br /> QGAS ROQFING Q SPEClA�TY �� C?THEF2
<br /> FINISHED FLOOR ELEVATIONS ��� FI.00D ZONE�RE4 C]YES NO
<br /> �� ,
<br /> BUItDEEt Q,� ` COMPANY
<br /> SIGNAl"URE �� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# C �
<br /> ELECTRtC1AN COMP�
<br /> SIGNATURE REGI$TEREQ Y/ N FEE CURRE� Y/N
<br /> Address , License# r '�'—".� �
<br /> (
<br /> PLtJlVIBER COMP,�
<br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N
<br /> �
<br /> �, Address License# � �
<br /> �
<br /> MECHAr11CAL COMPAF(1f
<br /> SIGNA7URE REGIS7ERED Y/ N FEE CURRE� , Y/N
<br /> Address License# � �
<br /> OTHEFt COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Address Licanse# � �
<br /> RESFDENi1At: Attach{2}Plot Plans;(2)sets of Sulidlag Plans;(1}set of Energy+Farms;R-Q-W Perml!for new construc�an,
<br /> Minlmum,ten(10).working'daysafter�subrnittal date. Required onsite,Construc�on Plans,Stormwater Plans w/Sflt Fence installed,
<br /> Sanitary Faciiides.&1.dumpster,SIta�Work•Pertnit for subd(visionsAarge proJects -
<br /> COrAMEi2C1Al,. At#ach{3)complete sets of Buildlrig Plans ptus a�ife Safe#y Page;{i}set af Energy Fotms.Et-O-W Permit for new constnsction. �-
<br /> Minimum ten(10)working days after submittal date. Requtred onsite,ConsUuction Plans;Stortnwater Plans w/Sllt Fence installed,
<br /> Sanitary FaciliUes&1 dumpster.Site Work Permit for all new prpjects.All commercial�iequirements must meet compllance
<br /> SIGN PERMIT Attach{2)sets of Englneered Plans., �
<br /> ••"*PROPERTY SURVEY required for all NEW cansUucUan.
<br /> Dlrectians: �, ,` :
<br /> Fill out appllcatlon completely. �, � '
<br /> Owner 8�Contractor sign back of appficarion,notarized�, � • ,.,...'
<br /> If over S25dd,a Notice af Cammerecement is required, (A/C�.upgraiies��aver�s-r�oa� -- �� ''� `,�� �R' � "'��- .
<br /> `" Agent(for the contractor)or Power of Attomey(for the avmer)would be�someone with natarized letter from owner authorizing�same =-• �•_ �� ,
<br /> DVER THE COUNTER PERMiTTING Front of- "tica#ion,4n1 �� „ �; . �� � � '
<br /> { p+PP, Y);'�=°;;,.:. ± '� ,;. - ; : _ �;,�,
<br /> Reroofs if shingles Sewer� Service.Upgrades A/C, „ Fe�ces'((?IoUSurvey/Footage) ���_ , . ; �� �,� . �,
<br /> Driveways-Not over Counter if on pubtic�roaduvays..needs ROW.� � � ,`� - � � 4 -� - - - .`....�, .
<br /> '. z ,.,w...., . , ...... .�,...._ �<.ri..=.. .> �.E
<br /> i
<br />
|