|
a��-�eaoo2o City of Zephyrhills Pecmit Application Fax-813-T84-0421
<br /> ' B+�ilding Department
<br /> Date Recelved Phane Cantact far permittin —
<br /> pwner's Name ` � —C�'�. Owner Phone Number
<br /> Owner's Address � ����� Owner Phone Number �~ - �
<br /> F�e Sfmple Titlehoider Name � � Owner Phoae Number �� �
<br /> Fee Stmple TiftehoSder Address
<br /> .�oa aoo��ss � ,��.'G,�t/1"1�lm�r� �.oT� ��
<br /> suaoivisiaN S'��.�/�i2 � p�lS� Pattce�ia�
<br /> (OBTAINED FROM PROPERTYTAX NdTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT � S1GN' Q Q DEMOLISH
<br /> � e lNSTA�.L 8 REPAIR
<br /> PR4P4SED USE Q SFF2 � COMM � OTHER
<br /> TYPE QP CON$TR!lCTION �BLOCK ' C] FRAME [„� STEEL Q
<br /> DESCRIPTION OF WORK P�" � �/�f� �.J� � �t���G�
<br /> BUILDING S12E � � SQ FOOTAGE C��1 HEIGHT ���
<br /> UILDING $ // ��O VALUATION OF TOTAI.COIVSTRUCTIQN
<br /> l�
<br /> QEI.ECTRICAL $ ��— AMP SERViCE Q PROGRESS ENERGY [� W.R.E.C.
<br /> QPl.UMBING $ ' �^��
<br /> �� ` �
<br /> OMECNANtCRt. $ VALUATlON OF MEGHANICAC IiVSTA�LArION �
<br /> QGAS [�'"�F2QOFING Q SPECIAI.TY � OTHER
<br /> FINESHED P�OOR EI.EVATtONS �� FIQOD ZONE AREA QYES. NO
<br /> BUtLDER � COMPANY
<br /> SIGNATURE REGISTEREp Y/ N FEE CURREh Y/N
<br /> Address LtcBnse# �" � �
<br /> EtECTRICtAN � COMPANY
<br /> SIGNATURE REC,{SiERED Y 1 N FEE CURRE� Y/hl
<br /> Address Licensa# 4 ���
<br /> PIUMBER � COMPAMC
<br /> SIGNATURB REG157ERED Y 1 N FEE CURREh Y/fU
<br /> Address License# �� �
<br /> MECHANiCAL - COMPlWY
<br /> SlGNATURE REGlSTEREd Y t• N �EE CuttREt� Y!N
<br /> Address License# C �
<br /> aT�t�� ��,l.;, � coMQ�wx �-$��1� �d d1'i�'�
<br /> .
<br /> SIGNATURE � __^_,_,,,_,,_� REGISTERED Y I N FEE GURREh Y I N
<br /> Address "� �� � (�� �" � Ltcense# �1�.."'��YD�y� �
<br /> REStDENTiAl: Attach{2)Rlot P.lans;(2)sets afxBullding'Plans;(1}sef of Energy�Forms;R-t�W Pertnit for new canstruc�on,
<br /> Mintmum�ten:.{1.0):working"days aftec subrritttal date. Requlred onsite,Gonstructian Plans;Stormwater Plans wt Stit Fence fnstailed,
<br /> SaNtary Faciiities-�1;dumpster,,Site'Work•Rermit for subdiVislonsllarge proJects
<br /> CONlMERCIAL Attach(3)camptefe sefs af Buitdirig Plans plus a Life Safety Page;{1}set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(1 Q)working days after submlttal date, Required onslte,ConstrucUon Ptans,Stormwater Pians wi Siit Fence instailed,
<br /> Sanitary FacilfUes&1 dumpster.3ite Work Pertrrtt for all neinr projects.All cammercial requlrements must meet compliance
<br /> SlGN PERMiT Attach"(2)se#s of Engineered Plans.= ,
<br /> •«'•PROPERTY SURVEY required for aEi NEW constructlon.
<br /> Direa#tons: � , • �� ,
<br /> F{N aut appticaUon compietely. 't, . ' ' �
<br /> Owner&Contractor slgn back of applicatlon,notarized•� �'� ' ` ' _ _ � � '� °" ` �
<br /> If over$25p0,a Not�ce of Commencement is required. �(AJC upgr8de�over$7500) "� " , - .��� 5 �,
<br /> '" Agent(far tiie aontractor}or Powec af.Attorney(for the awner)would be someone w(th notarized letter from owmer authorizing same _ r _ ,
<br /> dVER THE GOUNTER PERMIT7ING ' (Front of ApplicaUon'Only�.,°?' ,;;�� ' � �"
<br /> ,.,,. .
<br /> Reroafs if shingles Sewers Servide llpgrades�'AtG`�°�� ,:Ferices(PtatlSurveylFoatage} , � , .,' � �• ,:':t Y=
<br /> ,. � ;� �� . :;:, ,: .,� - .�. . ,. . , .. .
<br /> Drivewaya-Not over Counter if or�iputilic.roadways:.needs'ROW� , � '~ : ' ' ,� _ . , _
<br />
|