|
a�3aeo-oo2o City of Zephyrhills Permit Application Fa�cc 813-780-0021
<br /> . ''�~* BuiEding Department �
<br /> Date Raceiv�d
<br /> . . Ptione.Cantact.for Pa'rm�ttin --
<br /> Owner`�Wams � a�F��� � �j� Owner Phone Number
<br /> Owne�'s Address ��f� �(l[� 1� L.�/r�L-� G. � ' Ctw�er Phone Number � �
<br /> Fee Simple TlNeholder Name � " � "Owner Phone Number � �
<br /> ''r� . �..�
<br /> Fee Slmple Titlehalder Addre�s �'
<br /> JaB aoaReSS � �l� �/! . , ,, ,Z�-/yt� f�(�I�L,LS /�G.r � �.oT# ��
<br /> SUBDIVISION � � } PAFtCEL ID# - .
<br /> . .� (OBTAINED FROM-P.ROpERTY.TAX NOTICE�� '
<br /> WORiC PROP03ED ^NEW CONS7R` ADD/ALT C� SIGN" Q- Q DEMOLISH
<br /> e� INSTALL _ ,8 ,; REPAIR
<br /> PROPOSED-USE . Q SFR � COMM [� ' OTNER° 3 .
<br /> TYPE OF CON37RUCTION� � Q BLOCK �` Q FRi4ME Q STEEL �]
<br /> DESCRIPTION UF WORK EJ� �./ �S'1��� �~- L l G-N%;� �2, � �X��l� �,-';�,UI��,
<br /> BUILDING SIZE �� t�� ,J I�"f' SQ FCIOTAGE�___.�, , HEIGHT..�l�
<br /> 06UiLD1NG �� ,VAL.UATION O�F�'T�OTAL CONSI'FtUCTIQN
<br /> [�EIECTRtCA! $ �G �v AMP SERVICE '� PROGRESS ENERGY C] W.R.E:C.
<br /> QPLUMBtNG $ '� , ��,
<br /> QMECHAiV1CAL $ VAt.UATIt3N OF MECFfANtCAt INSTAt.lAT10N , �( ��
<br /> QGAS Q F200PtNG;._Q SPECIALTY � • OTHE#2 � ��j G/
<br /> [
<br /> FINISHED FLOOFt ELEVATIONS "� FLOOD ZONE AREA QYES NO
<br /> BUI�DER COMPANY ' �
<br /> SIGNATURE REGISTERED Y/ N FEE CURREK Y/N:
<br /> Address :, L"icense#=� ` �
<br /> E�.ECTRICU4N. , :: COMPANY ^ ��C/J��, �' �` ��L/.�G f�f'jC
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N�
<br /> Address 1 (2j �il� , �����j/ �L� � License.#;I; t,�-G'j✓��.�Jf" �`'�� �
<br /> PI.UMBER , , , ; GOMPANY<� . - : >, .
<br /> SIGNATURE � � vREGISTERED Y f-N FEE cuRrtE� . Y/N
<br /> Address - � L�cense#j� �
<br /> .t , ..
<br /> MECHANICAL „ . , .V . . COMPANY �, -
<br /> SIGNATURE � ,. R��isrER�� • � .Y./,_.N � " F��cu�n ,Y/N . ,
<br /> Addre�s= � � � � Ltcense.# ( . . �
<br /> , . }.
<br /> OTHER ' ; . � : ,,_COMPANY._ . �
<br /> SIGNATURE�� ' ` � � ` " 'REGISTERED Y/ N,_ - FEE CURRE�� Y/N ,
<br /> Addre�s . %:,�..°;.�- .` , . . . - �
<br /> , . ,License# � � I
<br /> �RESIDENTIAL-" s-;sAttach(2);Ptot;Pians;:.(2}sets:iaf 8�ilding°Piaos;�(:1}'sef�of Ene'rgy�Fiirni's;'F2=t3-W`Perrriit farnew ccnsbuc�an, � ..£
<br /> � Mlnimum�;ten°'(-1,0)Yworlcing;day,s;after,.subinitkaii:date:!Requiretl.onsite';Gons#rtiotlon=plans;Stomiwater`Plans w/Silt"Fence Installed,
<br /> �Sanitaty�Fadil6ies;8��;1�dumpsterSite_Worlc;Recmit#arsutidiVisloctisllargeproJects ��:<:�•�: _ � : t. ..
<br /> COMMEitCOAL Attach(3)�oompte#e'sets'of Buiiding`Plans-ptus a Life'Safetji Page;(1'}set of Energy Forms.R-O-W Permit far new construction.
<br /> Minimum ten(10)worktng days after submlNal date. Required onsite,Construc8on Plans,Stormwater Plans w/Siit Fence installed,
<br /> Sanitary Facllltles&1 dumpster;S�te Wark Permlt for aii new,projecYs:-A!i cammerctal regutrements must meet compllance `
<br /> StGN PERMIT Attacti"(2)'s`ets of Eitgineereci•,Plans.;',a . . _ . ,_�. _, - � °� ' , - ` '
<br /> •'•'PROPERTY SUR1/EY reguired for all�PIEW_consUuction.
<br /> DirectFons: � ... . - ,_ � �
<br /> ' FIII out appllcatlon ct�mpletely.
<br /> 4wner 8 Gantractac slgn badc of appltcatlon,notaciz�i
<br /> If ovgr S25Q0,a Notice of Commancement Ia required. (AIC upgrades over$7500)
<br /> ��'' ���'.7:!j���:�,� ., .
<br /> !R .,....'� .. _ ._.....r... ... . .
<br /> Agent(for th+a cantta�cto'r`)ar'Power of'Attoiitep(fci'the awner)woutd be someone with noterized letter from owner authorizfng same
<br /> DV,ERTHE COUNT.ER,RERMITt1NG�-�,����•(Fiant-ofApplication�Only)°•�:,`�:�j�µMf�� ,
<br /> ,,
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) `
<br /> . .�._. �, . '
<br /> Drivewaya-Not over Counter if on publfc roadways.:needs ROW ,
<br />
|