|
a��-�ao-aozo Ci#y of 2ephyrhills Permit Application Fa�c 813asaoo2�
<br /> � = Building Department_ .
<br /> ;: .
<br /> Date Rec�ived . . � :: ..Ptiane Corit�ct?for`Permittir`i �:•,: �. .
<br /> , --�-} •-�' ' '
<br /> Owrte�'s Name �-'' "7 v � � ' l.r L`� Ownar P.hane Number ,
<br /> Owner's�►ddres� '°;= ` � , • . . . �wner•Phone Number '
<br /> .
<br /> � �
<br /> Fee Slmple Tttleholder�Name� ��� ' °} ' '�� � Owner Phone Number t � _
<br /> .. . , _ ;�'��._.---, .. .3! -- -, . . .. . �.�.�.
<br /> � �
<br /> Fea 3imple Tltlehalder.,�►ddre�s •}� - � •- - � �
<br /> JOB ADDRESS ,,;/ � �� �` f'7 - LQT# �__�
<br /> SUBDIVISION � � �PARC�L ID#' . ' ` �
<br /> � - , . • , � - ', .,(OBTAINED'FRQl�PROPERTYTAX'NOTiCE} ,
<br /> r=
<br /> WORK RRt)PBSED `• NEW CBNSTR <� �' 'ADD/ALT Q S1GN -0 Q� ` DEMOLiSH -
<br /> ' e INSTALL �:8: ;;-REPAIR ' ',
<br /> PEtOROSEO USE Q`; .S�R '[� -CQMM', Q OTHER`_ � - _
<br /> � �.� ,.. .
<br /> TYPE OF GON�7RUCTION:: ' �'0-� ':BLOCK'`• 'Q, FRAf1AE, , C� .STEEI.� �-��- : �..
<br /> _ Y>� . .,. , <
<br /> DESCRIP110N OF WORK ' � 'l� ,�^�� � -�y�l/ 1(��CJ ,C � �
<br /> BUILDINGSIZE '�!� � ' � SQ`FQOTAaE���. . ,_.HEIGHT ,� _ .
<br /> OBUIlQ1NG $ ,�,�,�`;.�°_ � _-,"=n,� .......... .. .
<br /> , 'VAI,UATION�'O�TOTAL`CONS7RUCTIQN
<br /> ' �, . .
<br /> Q�LECTRlGAL $ �i -��;j ,,;'�' : iqMP gERVICE 'Qt PROGRESS ENERGY [�� W.R.E.C.
<br /> o� �« J
<br /> ���uMeir�� � � '� �7 ('
<br /> �_ 'I . ,.. - .��, l.. � �,�,
<br /> _ _, . 1E("
<br /> QMECHANtGAl: $ " . VAl.tii4TION,OF MEGHANlCAL CNSTALIATiflN -
<br /> QGAS Q : ROC?FlNG,�;����-� ` SPECIR�IY��'�`- QTIiER - �"��
<br /> �
<br /> FINISHEp FLOOR EI.EVATIONS � � FLOOD ZONE AREA �YES. N4
<br /> BUILDER GOMPANY` �. ,` � - - , � .
<br /> SIGNAYURE REGISTERED Y/ N.. " �E Cu�� ; Y/:N:, : ,
<br /> Address • - l:icanse# � �
<br /> ��
<br /> . ; , c :
<br /> /� .x;
<br /> ELECTRICU1Ft-� � /��r ���/,S�' � „� '�`.COMPANY � "� ��Q� G� - . -
<br /> SI�iNATURE �✓� d''1 �� REGISTERED Y/ N FEE CURRE� Y./N :'' ,
<br /> Add�988 �c���ar V �d? _ ��(,� ' . � ;F .°,I�cense#�., � '�/ .Gv� '
<br /> Pi.UMBER ,. ' � � ,. _ GpMPANY= :,' ' � . : ;. .
<br /> SIGNATURE ; " . .. , . ` ' ', ;REGISTEREP' � . � %-'Y"/}.N:= ; FEE_CURREh' .. `,Y/N: .
<br /> Address � . . ., Ucense#�� -�
<br /> MECHANIGAL`;� , ,_ � , ,. '>�� . :CQMPqNY,., �; �,.,, t �'-;.,: , _ .-. _
<br /> v;..�,:�:
<br /> SIGNATURE ` � "�- " ' � � ,REGIS7ERED ..Y;/'N�.; . '�FEE.CURREN� �Y/�N�;� � -
<br /> Addresa� .�; ��.. , .: .- �.. , �•� .` , _ ' ` " Llcense#�I. ... ' • , I
<br /> OTHER � - _. . . , ._ . �,�.. ., � ,CQMPANY;, ". �.'... � _
<br /> SIG9NATURE,�. -`'' . • .c�' , . � � .�. _ � , REGISTEF2ED._ _ `Y;/_N,.�; ,FEE.'CURREA' Y.I�Nc:.
<br /> _ ' ._, ,=Si:':; , ,.. . .. .
<br /> /►ddre�as ;��� _-;:x ,��w�;:��'�''<; .s '' ..- _.. �.. . ' ` tLicense�#�I �
<br /> '.''r.
<br /> . . . .,;'.;, . .. , .;_ .. ..
<br /> : . , Y ,':�;� ' �_ . � ; . •+.' �: xt�":'`. � .r,- ..-.ti-:�:,�t ,•,��. : , . .... . , ..__ .
<br /> RESID6NTIAL: �'�:Ai#ach,(2};;Plot�P.,lans;�{2jisets:oi�Bullding��Plans;�(4:}'seti.of�Ene"rgy�Fo'mjs;=R-0-1N�Reri»if:fornei+v�constructibn,.;:
<br /> .;.;Mlnlinum:ten;,(+1Q)�worlting�,daysM�a[ter,:submittniGdata:�Requlred onsite;�ConetivoBon,Plans;-Starmwater�Plans`w/=Stlt Fence in'stalled,
<br /> ��SanllaryFed�itfes&�s1�i�u�pster,Slte�Wartc�Permit;forxsutiditiistorts!latge°PmS.�'•-:;`:�;�°f•�';'''��:,•� .. . � , ". , �- .
<br /> COMMERCiA� Attech(3�`c;�inptete'sets af Bulld[ng Pians plus a L�fa Safety Pege;(1)set of Energy Forms.RA W Petmit for new constructlon.
<br /> Minimum ten(10)working days'after submittal date. Requtred.:onsite,ConsWction Plens,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Fadl(�es&,1 dum�tster..Slte Wark:l?ermit.tor�alt'new�proJecks'�Atl;cammerciaf�cequitements:must�meat:comp4lance
<br /> SIGN.PERhAiT Attacfi'(2)set"s of`Engi�neer;e�4Pians:,;,;�;.�=.�`'�'�. _ ,. - _ . , �
<br /> M•��PROP.,ERT'1!SURVEY�regulred;,fqr�all�NEItV consducdon.::.,:. „ - �� - .. . .
<br /> - 4�
<br /> Dtrectlons: z�.:t:,.. ._ �,, .,.. .,.u.._._..... , .., .._ _. __ .. _. �
<br /> Ffll out applicadon completely.
<br /> t�inrner�Contractor-sign back_of.appllcat�an,aat�rized
<br /> If over 52500,a Notli:e,of,Commenc�ment is re uired. WC u rades aver S7S00, "
<br /> 4 -__�....._. P9w._ _ ',, .. .
<br /> .� -"''Cys,x;:�-,er�j.?z',.:r • .�..�..:., ..�...<.._.,,,,.�.. _.,«...._ _ .
<br /> � Agent(forttie oontractor)'or:Rower'of Attoiney jfor Uie owrierj would`be sotneone yvlth notatized letter fram awmer authodzing same
<br /> DVERTHE COUNT�R,PEIUAITt`ING;=:_.:='(Front�of�i4pP11cadon Qnlyj:;-,.� - :- .�.:,_�,��:_>u , _. - :
<br /> Reroofs if shingles Sewers Service Upgrades.NC'� �Fences(Plot/5urvey/Faotage) _ .. �.- -•- -
<br /> .,.,_..� �..+-:.-.�._. ......�-��. .. -e .. �.,.__ ..�.-.3` ;,.,z't i��ti' _ r � ' 1' ' �' •, � • •
<br /> Drivewrnys-Not over Counter if on pubUc roadways.:needs ROW! ,
<br /> ..... .. ...�,---
<br /> �
<br />
|