|
a��-�eaoo2o City of Zephyrhills P�rmit Application Fax-813-780-0021
<br /> , , 8u(Iditig Depattment
<br /> s -
<br /> Dats Received 'p�pna�Caotact far Permittln . �
<br /> Owner's Name ner Phone Namber
<br /> Owner's Address � ^ �" Owner•Phone Number �— ��
<br /> , 1,,, � � � �
<br /> i }
<br /> Fee 8lmple Tltlehold�ar Name ,J- Owner Phone Nuimber ,
<br /> ,.
<br /> Fee 8lmple Titleholder Address �
<br /> JOB AbDRESS LOY# ��.�
<br /> SUSDIVISION �� � PARCEL ID# -
<br /> (OBTAINED FRQM PROPERTY T/U(NOTICE)
<br /> WORK PROPOSED NEw CONSTft RDD/Al.T � S1G#3 Q • Q DEMOI.ISH -
<br /> h INSTALL 8r' R�PAIR
<br /> PROPOSED klSE Q $Fi2 � GO[ulM [� OTHEiR
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FRAME � STEEL. Q
<br /> _ �...
<br /> DESCRIPTIQN OF WORK
<br /> Bt1iLDlAifa�SIZE ° : - � ` -
<br /> � � SQ FOOTAGE��^� HEIGHT C��
<br /> 08U1l.DING $ `���--x__ ,�� _. _ �
<br /> - �_ VALUATION OF TOTAL CONSTRUCTION
<br /> QELECTRIGA� $�'~ � AMP SERVICE Q PROGRESS Et+tE12GY Q W.R.E.C.
<br /> ��
<br /> PlUM81NG '
<br /> � � `
<br /> OMECNANiCAL �� �VA�UATION OF MECHANICAL INSTAL[:ATIOIV
<br /> OGAS �~ROQFItVCa� .Q SPEGIRt,.TY �� OTHER •
<br /> , FINISHED FLOOR ELEVATIONS ��� FL.00D ZQNE AREA �YES. _ NO
<br /> BUILDER COMPAl�IY �
<br /> SIGNATURE REGI87ERED Y/ N FEE CURREK Y/N
<br /> Address Licerise# � �
<br /> ECECTRICIAN COMPAt�tY �
<br /> ' SIGNATURE � REGI3TERED Y/ N FEE CURRE� Y/N
<br /> Address , �.License# i �i i
<br /> PCUMBER COMP.ANY� �' ,
<br /> SIGNATURE , REGI$.TERED Y/-�N . • FEE CURRE� Y/N
<br /> Addre�8 � LiCQ11Se# �� 1
<br /> MECHANICd11: . COMPAAt�I]Y
<br /> SIGNATURE � ' " REGISTERED Y;/ N ,FEE CURRE� . Y/=N .
<br /> Address ` � { � Llce� #
<br /> OTHER ,COMPAI±3Y
<br /> SIGNATURE= RE��sTE�o / N.: FEe CURREn �. Y�/N..
<br /> Address :. ;_����<""�' ' � '''License# �� .... .�
<br /> ,� x.. ..:. . ,,�.<. �>., .
<br /> _. �,;,,.,,r.�, •..;.s._ ._ ..:. , � . - - �
<br /> RESIDENTIAI;;. : �'Attach..{2);.Plof:.P.lans;;{2}.sets:of�8uitdlitg`.Plans;(1)setof�Energy�F�imS:R-O=W.F*emiit.foriieinr,c,cnstrucfion,
<br /> :...... ... .:: . .,,
<br /> Minimumt:tens(,10);working;days�a�te�;`sub'r"rilftal'date.�.Requlred.onslfe;�Const�ucd'an�Plans;}Stormwate�'plans w/Sllt Fence installed,
<br /> � �� ��3aniteryFaciltdes:��l:,dumpster�5lte�Wo,r,k':P,,ermltfor�sutidiv_IslonsAarge,'=projects= . -,�;'�� `: .. �k`
<br /> ;�a,
<br /> COMMERCFAI. Attach{3)'cainplete sets`of Bnilding Plaiis'ptus a Life Safe#y Page;{1}set of Enargy Fotms.t2-O-W Permlt for rtew cortstructton.
<br /> Minimum ten(10)working,'days'after submittal date. Required onsite,Construcdon Plans,Stormwater Plans w/Silt Fence Installed, -
<br /> Sanitary Fac11[8es&1 dumpster.3ite Work Pertnit for al!`new'pridJects.AJI commercial requt�ements-must meet campltance
<br /> SiGN AERMlT Attaci�{2}"sets of'Engineer.ed�P.lans;i:�;;;�;�`� � . ' ` '
<br /> """PROPERTY SURVEY�eguir�cl,for;all NEUV cansWcUon. .
<br /> Dlrectlons: •.'Y�.:;,,..
<br /> FIII out applicatlon completely.
<br /> Qwner&Contractor slgrt back-of appilcatian,notarized
<br /> if aver S2S00.a Notice,af Commencement is required. (A!C upgrades over 57540) -
<br /> '•`,S:r,f_;t ".
<br /> `" Agent(for the5contractor)or:Power�of Attomey(fo��the�owner).wauld.be someone with notarized letter trom owner authodzing same
<br /> DVER TH�COUN'TER..PERMiTGtNG � (Front-of Appticai�on Only)• i ' ' "
<br /> Reroofs 1f shingles Sewers Service Upgrades A/C " Fences'(Plot/Sunray/Footage)
<br /> Driveways-Not aver Caunter if on pubtic roadways.,needs ROW.,, ••
<br /> — _ '
<br />
|