|
a�aaso-oo2o City of Zephyrhills Permit Application �ax-813asaoo2�
<br /> . � Building Departrnent
<br /> Date Received:, , � , �Phana�Goritac#;far:Permittin °��' �
<br /> Owaer's Name �, S t,t��, '!'1 Gl(r'1 ^ . Owner Phone Numb,er .
<br /> Owner's Address • « -, -' ' Owrnec•Phone Number � "� �
<br /> Fee Simple TldehclderNam� � '� Clwne�phone Number � _�,� .
<br /> - '�7� , . -
<br /> , b . ..
<br /> Fee Simple Titlehalder Address •'�� '
<br /> JOB ADDRESS ���n r1 e I LOT# C�
<br /> SUBDiVISMON I �-'"Y' '��,rll�/� ��rJ)� P�I�IRCEL ID# ' - -
<br /> . � • (OBTAINEDFItOh4'PROPERTYTAXNOTICE}- _>
<br /> WORK PRCIP.OSEi3 y NEW CO�vS7R � ADD/ALT � ''SIGN � � Q�, DEMOLISH �
<br /> - e ' INSTAl:L •8`-� :REPAIR ,
<br /> PROPOSEDtISE. Q � ' �SFR ' � ; COMM-' � OTHER� .,
<br /> TYPE OF CONSTRUCTION; �Q �BLOCK�' 'a___ f� FRAME � ;ST,EEL Q�
<br /> ��'�� . S����
<br /> DEBCRIPTION OR WORK � 1 u- ��� ��'� 0�Y'Y� . . �L(„r YL�OJ -
<br /> ; . . . _
<br /> , : , . .
<br /> :
<br /> BUILDING SIZE, SQ FQOTAGE� -�� - , ,.:HEIGHT::.�., . �:
<br /> 08U]LDING $ --fi:.�;��:;:.. ,.�__���_ . . '' ,� .
<br /> - � , VAl.UATION"aF TOTAL"GONSTRI'JCYION ,
<br /> �; . ., . . •
<br /> [�ElECTFtiCA! $� I C� p� . AMP"SfRVtCE Q PROGRESSENERGY' 'Q, 1N.R.E.C.
<br /> CO 4.7 �
<br /> �Pi:UMB1NG ��� . �� -
<br /> _ s' . - /(,� -
<br /> QMECH11NtG�L' ' $ " �VALUATION.OF MECNAttilIGA�II+fS7'AI.L.AT10N K
<br /> .,. , . . ��� �
<br /> C�Gas , � ,. �ooF��v�:,.�ti0 SPEC1Ak7Y�•Q� 03NER° �` ' ��'„��}l
<br /> FINISHED FLOOR ELEVA710NS FLOpa ZON�AREA �YES. NO• � �"��
<br /> BUIi.DER GOMPANY`: -` �
<br /> SIGNATUP2� REGISTERED , YY N. �� `FEE CURREP`'�;. �Y/.N .:r, : -. : , .
<br /> Addre�s - L:I�ense#� , �
<br /> , . _ . . . . n. � � :t� �r ,�.�,�,� .
<br /> ElECTRtC1AN:�:,`.• ; (� �, ` GOMFANY A�� �I I' , �tr� ��`C 7 f'• ��
<br /> SIGNATURE 7 � � REGISTERED Y/ N FEE CURRE� .Y%N '
<br /> . , ;,. �
<br /> Addre�s .. ., . � �. � � �; � . - .',License�#����� -` �
<br /> PLUMBER � GOMPANY- : . -• _ ' _
<br /> SICaNATURE's , . �. , �FtEGIS.T,EREP; . --C,Y.'/•xN � :Fee:cuw�n ,� .� Y/'N: ' ,
<br /> Aaidre�s .�. � � ", , , ..License#•�� � �
<br /> : . . - .. .,, . � ,:. . , �
<br /> MECl�t�i411CA1'.: � F. - � :GQMPANY "`� � �-- - : .
<br /> ,�;�
<br /> SIGNATURE . "'�• . '., ' � RERIS7EF2�D.: , :`.Y:/'N. , ,�E.Cutt�n� Y./-N�t..,
<br /> AddresGs.;�.` ` . . : ,_ .. . ,. . - . ` , r .:Ucense# ��.t�.. ... �' _
<br /> � OTHEit :x -, . .. _.'<.:r_ ,. ._ • `GOMPANY: .. : ,e,_-�,::: _.4..n . �, � ; . ... �.` .
<br /> SIONIAYURB. . ��.. , ,,` . : , � RE ISTERED - Y/: N,�; ,� ,
<br /> G E CUR�n _ �.Y.J•N:.. ,
<br /> .: . _ .. ��, .', �-.-, '
<br /> Addres� ,;� , ,. :,����:: .sh��,;._-.,,.. p.-� _ . > . _ ._ ._�.L''Icense#�I`- ' �:
<br /> ' " ' _t�x�j •�h _ - -•k �xi��,.., <<.Y _ :�"c�+.� e.. �,�.�`��. -,i.�.�^-44� '"'"�t. ,�::.t'!;� , . .,.... _'
<br /> RESIDER�lTiAt:•., Attarlt-,21;._P.;1o`�p..1an`s;.[�2�:sets�of,Bultalnp P,tans;.,9jset of�Eiie��y�yjj�Forins:`R=Ci W�Perniif:fcrneu}r;,coiistnictl,on,. �
<br /> .,t �. / - \ .� , i7. � . . �iT7... r�.,. ... �.
<br /> - r.Minlr�ium�ten:(�1Q)worlti,.n.g;:days�atte�„;su6ri'iiftai�date:��Required:onslte;-.ConsinioBon�Plans:-Stb"Rnwater'Plans'Vir%-SIIkFencetnstalled,
<br /> . r � ,
<br /> .... :,SanftaiyfFac�itti4s&s1#s�ampster,.Slte;lNoik�Per.m�t.(cr:siitidiv!'sior'istjarge proJects ` :y�.P; °:;,,;,. .- ; ..= � „:'�. .. .. .
<br /> COMMERCiAt Attach(3j complete sets cf'Bu�itding Plans ptus a life S�afety Page;(1}set of Energy Forms.R-O W Permit for naw Gonstnictlon.
<br /> Minimum ten(1p)waricing days'after submlttal date. Requ(red onsRe,,Cons#ruction Plans,Staanwaker Plans w/Silt Fence Installed,
<br /> Sanitary.Fac�Ktles&1:_dumpster...Site.,Work.Permit.for ati^new;praJ"e`ct's:Aii,00mmerc�al.requi�ements-must:meet:campilance . _
<br /> � � � -• �_ -
<br /> , SiGN PERMiT Aitar.�(2}°§et§of'Eng"i�i�eiedl?lat�s:�;:;�:ir:�,u:-:�. : =. ,� ; . ,� .
<br /> � ""••PRQPERIY.SURVEY.requlred.fnr aI.I:NEW,cons.tcucyon., - , � _ - �
<br /> - •:.,
<br /> Dire:ctions: _�=_:, . ., . ,r, - �. _ . ..... ._. _. � . . ,
<br /> FIII out epplicatlan ccmpletely.
<br /> Oinrner&Contractor stgn back of appltca#lon,notarized
<br /> If over.�2500,a,.Notice of.,Cammencement la requtred. (�11C upgrades aver=7500)�, s: . ._
<br /> �"':;":?''7i'tiri`�Sjj{'.'i'�'
<br /> " Agent(for tfie contractor.)�oi=PoV�er of•Attoiiiay(for tlie�owner)woutd'be someone_with,notarized letter from owner authodzfng same
<br /> ..,. . ,
<br /> .,...� � .,.
<br /> "OVER'THE"COUNTQR:PERMITTfPti3::':=..=�(Frcnt�of�i4pP11caBon Oniy)=
<br /> Reroofs If shingles Sewers Service Upgredas /�/C Fences(PIoUSurvey/Footage) _ _ . _.... ... .... . . - , � -
<br /> - _ `'._ -�., -� _ .. F. _ : . "" t ' '" . �. .. .-, .,_ .. ' _
<br /> DNvew�ys-Not over Gounter If qn`pubtic roadweys::n'eeds ROW `
<br />
|