|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> � .. -
<br /> „ ..
<br /> Dateiteceived _ _ • . - �-P.hone-Contact<for`Per'mittin`'`��' � • — �
<br /> �
<br /> Owner's Name � Owrner,Phone Number �� � . -
<br /> Owner'a Address � ��� � ' Owner•Phon�-Number
<br /> Fee Slmple�Titleholder:Name'°J�^ � Owner Phone Nuenber '. ; •�
<br /> ,_ _. , . . _ �i�e, t _ ^ .
<br /> Fee s�mp�e r�e�eho�a.�_l�aare� � , .- . � _
<br /> JOB ADDRESS LOT#„ � .
<br /> SUBDIVISION - PARCEL'•ID# ' � ' � .
<br /> - � ." . �. . (OBTAINED�FROMI PROPERTYT/U(�NOTICE). � ��
<br /> IRIORK PROPOSED `,'' NEW CONSTR • '� �� ADD/ALT Q `SIGN " �Q � ' Q�r DEMOLISH - ,
<br /> _ , B y'�'Y INSTALt �B ,- =,REPAIR ~ � .
<br /> .,<.: _. ...._
<br /> PROPOSED.USE-• , Q SFR Q 'COMM', Q ' ' OTHER,'� "'` `
<br /> TYPE OF CONSTRUCTION°; � .:Q;; '�'BLOCK•'• �Q ' � FRAAAE; _ Q STEEL Q� �,�-. , •
<br /> DESCRIPTION�OF WORK f' ~ �..JC.1'���'. ' ' , i V - -
<br /> BUILDING SIZE'' ` ` `$Q FOOTAGE�-.s - ,_HEIGHT:.:,- : =-� _ '
<br /> _. QBUILDING S . ;- -�F�;�:;�::�,_, ,...v=.�,,..: . ,, . -yJ . .
<br /> •VALUATION�F�'fOTAL CONSTRUC710N . ,
<br /> QELECTRICAL $ � -�"AMP SERVIGE Q �PROGRES3 ENERGY Q, W.R.E.C. ._
<br /> QPLUMBING $: �' _
<br /> , ... � , , . . . ����-
<br /> � " �
<br /> QMECHANICAL ' $' ` ' . `VALU,ATION;OF.MECHANICAL.INSTALLATION . � ��
<br /> , , , � ( ��
<br /> QGAS ,Q -,ROOFING:,.;Q SP,ECIALTY-�Q ' OTMER�= � �" �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO _. . •
<br /> ; r•���o-, . . ' *, � , .., • -
<br /> `i
<br /> BUILDER COMPANY K `
<br /> SIGN�►TUR� REGISTERED Y/ N. ' �e CURRE�'_,�, "Y 11!1�. ;,,.', ,
<br /> Addreas � - , ` License# "
<br /> ELECTRIC ,- • . 'COMPANY ' �,S .���!G�
<br /> SIGNATURE ��M REGISTER Y/ N FEE GURREK ' " '.Y/N .' .
<br /> , _ . , .. . .._,Y .-^,_. ._ .
<br /> Address � `, x ,• .%.Gcense:#:''`�v, '
<br /> PLUMBER ' � . COMP.AMI�, ' - , , � ,
<br /> SIGNATURE� '� � '� °sREGIS7ERED" , ..��:�-:�Y!�N - ,.:�e cuw����-,, �Y/N:
<br /> Address , .�_ � , ° .. -- , Ucense#; + , , �-
<br /> RAECHAPIICAL V, , �. . �t ,_ � . _ { (. . >COMPANY- ��� ;_- . �. �''::,;:,. - ,;;� - � = -� -
<br /> SIGNATURE ' `�' •- - . . . ,A - ` REGIS7ERED:: , ;Y:/.N� ,:;FEECURREN . �.YY-N�;:°;
<br /> � ,� , _ ' .. -. .. , ...._ .. �. , . , _ .
<br /> Address��-. , r. . - .�...._. . ,. . .. � � ,. ,License#�. - .. �� ;� , . _
<br /> .�f� ... - � . ' "JJ:. . t�' � � �..� ` ., =. ' ' . 3 : _ . ,�. .. �. �. . ..� . . x "
<br /> OTHER �. ._..,, ., ,. .�._, .• � COfIAPANX., . ,: .:.;.:�:. �. •:u•.-.:. :.,;.:..: :-;,: - ,
<br /> �� . ,_ r..� . ... . ... .... ... . ,. ,�., . .,
<br /> , StGNATURB - � v� � ',REG►srEriEn- \-Y,/ N='.' �FEECeURi3E�:` Y�/,I�l.�� � ,
<br /> a".:, , ,.
<br /> J:i. . , : ' ''. �± - �
<br /> Addr�ss Y Y�t.� >� �f � - � .. : -`License#� �
<br /> ,,.:. � _ a.x�_r.. -�F= �,y;.<-, -:�;-s;_ . .. .... ,
<br /> - I, k'"_ ' .�3•° �ei`' <-2"' 'Ss'` — .';c'�' - r':�':f.�'•:.``i:A'sq'��'_ _
<br /> -'�;:.t: - _ '"!:•� `� ..R=O=W:Permit.for.new:;con trtiction;:�- , -
<br /> - .Attach�2<Plof P..,lans�z�2�.set's'=of;B►��Idl'n Plans;-�1 •seti'of�Eneigy Forms,. §..
<br /> ,.. . .
<br /> , _. :_ -�.�
<br /> .,,RESIDEWTIAL-.:: ,, _.._ ..��.)�.;.__�... ., �.�.). ..,. -�,... . 9,f �_.),....,. - -
<br /> t,,, �,:r.�
<br /> i' m�ten..�1 'workin :da�s.�after;sutiiiilftal�dafe:Y Requited.onsite;tConstnictlon�Plans;�Stomiwater.,Plai�s w%Silt Fence:Installed, - ,
<br /> �._.'�M nimu ,(�Q�� ..9,- . .
<br /> �� ,�. �r .Y.. _ . � . ,.: . . .. ;.•;�...¢��.,.-,r:: = . -- - - =F
<br /> , Sanfta SaFe'IIdQs`&s;1�;uin'�s_tei;°Sit��Work�Per,niit';fo.r:;sutidi`rislon&llerge:projects:;:�>.`��,. . . .. _ _ . , _
<br /> ry ;�,�:a:-�t,�:.H,,�.t�.,,R,.-�G , w:��._,�r.:.�.._..,.�:..:.- � ..::,:., - •:.. ,. -:;.•_;_ ,� .�` "�.
<br /> COMWIERCIAL Attach(3)'i:ompl'ete sets of'Buliding Plans plus a Ufe Safery Page;(1)set of Energy Forms.RA-W Permit for new can'strucUon. _
<br /> _ _ Minlmum ten(10)wadcing days after submfttal date. Requtred_ons(te,,Construcdon Plans,Stortnwater Plans w/Sllt Fence Installed,. - ,
<br /> Sanifary FaGlides.&1 dumpster.�Sito Work.Pertnit;for,�Il'newiproje�;mAll'commercial:requlrements�mustmeat_campllanca ,
<br /> SIGN PERMIT Attacii(2)sets o"fi'Englne`erediPla�s;� „��:t'�• . . �" _ . , " - - . � . - - _
<br /> r
<br /> `•••PROPERTY SURVEY reguired�orw�Il NEW_-cons.trucdoo.. - � _ ' -_ - _ , . �
<br /> . � H.� �:,;. -- ,.,
<br /> : . .,
<br /> p�4;..'Ft�•
<br /> . �Dlce',c'�Ions: ..�>�::�.��?<-- .. � -_-.�. .._ ., . _. ._ -- __ _ . _ .
<br /> Fill;out applicadon campletely.
<br /> Oinrner 8 Contractor sign back.of appiicaUon,noWrized
<br /> If�over�2500,a•Noticte,:of,:CommencemenE is requlred. (AIC upgrades oy�r 57500), , x r. . ...�_. -
<br /> .. °i,�'h:s;t;:,,�.,i;;.:; =
<br /> Agent(for Uie canttactoc)'pir'Power"of:Attoiney'(fo�the:owner)wouldYbe someone with notarized letter from owner autho�izing same.
<br /> :OVER=THE COUNT�R,PERMITTINt,:-:=,=:,:".(Front;ofApPlication Only)��-���":=:� � ',,:�.. �� ,
<br /> Reroofs if shingles Sewers Servica Upgradas�`A/C '_� Fences;(PIof/Survey/Footage) _,. _ -_..-- - --- , _ : 4-;=,+:,;:f -- . ` ,-.E, ,, •
<br /> _:,...., __.n:._ —_� :_.,.._. .. -� ._ ..,.;.,;'':;._T:.`;�:,„��,�.:- ;;i: ,2...:� +, .. -, •
<br /> .. � ._ .. . '.�.t_',R..:,_„_. . ,+•.
<br /> ._,..,.:.,.�
<br /> Driveways-Not over Counter if on pablic roadways,.needs ROW ��` .4 '
<br />
|