|
813-780-0020 City of Zephyrhills Permit Application ��X-s�saso-oa2�
<br /> t � Bullding Department
<br /> Data Received Phone-Contact far Permittin –
<br /> Owoer's Nams Q !��"~l. Owner Phone Number
<br /> , � �
<br /> Owner's Address (p S�� .Sl�,.(/�/L (�G'��,�' �i,� Owner Phone Number
<br /> Fee Slmple Titleholder Name �— � Owner Phone Number � �
<br /> Fee Simple Titleholder Address
<br /> JOBAbDRESS .?'�� �/ U��. m�S � L.OT# �"�
<br /> SUBDIVISION S l G-1jGIL- ���L�j � pARCEL ID# �3� �—2..1-- �I �D— A OlIO� p 2�
<br /> (OBTAINED FROM PROPER71f TAX NOTICEj
<br /> WORK PROPOSED , e NEW CONSTR�ADD/AtT � S1GN• � Q DEMOL�SM
<br /> INBTALL REPAIR
<br /> PROPOSED US� [� SFR Q COMM � OTHER
<br /> TYPE OF CONBTRUCTION �'"""/BLQCK R Q FRAME �] STEEL Q
<br /> DESCRIPTION OF WORK �po� Q 1�17? �� /� J �L�` � //`//i»��C�S
<br /> BUtLDING SIZE ��—� SQ FOOTAGE HEIGHT C��
<br /> �$���'���� $ � VALUATION OF TOTA�CONSTRUCTION
<br /> � '��
<br /> QELECTRICAl. $ AMP SERVICE Q PROGF2ES5 ENERGY C] W.R.E.C.
<br /> QPLUMBING �"� ��.}��
<br /> OMECHANICA� $ VR�UATION 4F MECNAN{CA�INSTPa.IATIt}N �
<br /> QGAS [i/ �' RC?OFtNG Q SPECIALTY [� qTHER
<br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZQNE AREA QYES NO
<br /> ', BUIIDER COMPAFiY
<br /> I $�IGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> ' Address Lfcense# � �
<br /> Ei.EC7RIClAN � COMPAt�1Y
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres� License# C —�
<br /> PUlMBER COMF.ANlt
<br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N
<br /> � Address License# r— �
<br /> MECHANlCAI. COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> ' Addres�
<br /> License# r� ��
<br /> OTHER �/ COMPANY tJl� ��ll�J�l��
<br /> I SIGNATURE „cit.C.� �,�fhl'7��/ REGISTERED Y/ N. FEE CURRE� Y/N
<br /> Address � �1� .S�3 �f�/�� �!`Z' ,� License# ���7�p,�-�� �
<br /> E2EStDE1V11Ai. Attach(2)Pldt�Plarts;.(2}sets�af.Building Plans;{1)se#of Eriergy�Forms;R•0=W Pertnit for naw construc�on,
<br /> _ Mlnlmum ten_(10):working days.aRer submittal�date:-Reqalred onslte,Construction Plans;Stortnwater Plans w/Silt Fence installed,
<br /> Santtary FaciltUes:&1.dumpster Sfte�Work�Permit for subdivislonsflarge'projacts
<br /> COMMERCIAL Attach(3)comptete set"s of Buildirig Plans plas a E.ife Safety Page;{1)set of Energyr Forms.i2-O-W Pennit for new consUuctlon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Pians,Stormwater Plans w/5ilt Fence installed,
<br /> Sanitary FacAitles&7 dumpster,Site Work Permit far al!new proJects.A!I commerciai.requlrements must meet carrzpflance
<br /> SIGN PERMIT Attach'{2)""sets of`Eingi�eered P1ans.;� ��
<br /> •`••PROPERTY SURVEY required for all NEW conshuctian.
<br /> Dlrectlons: .
<br /> FIII out applicatlon completely.
<br /> Owner 8 Contractor stgn back of appiica8on,natarized
<br /> If aver 52500,a Notice of Commencement ls raquired. (A/C upgrades over�,�500j
<br /> " Agent(for the contractor)or Powe`r afAttomey{for the owner)woulr!be someone with notarized letter�fram.owner authorizin�same
<br /> i
<br /> OVER TFfE COUNTER PERMt1TING' ' ' Front ofA'�Iicafiiin Oni" "; � '',- � , ,
<br /> t , . pP Y) i .. . j.-_t. ...,.,..,._..�+,1,:,, ,r
<br /> Reroofs if shinglss Sewers Service;�Upgrades;i4/C� `�en�es(PIoUSurvey/Footage) � � ��'��� �•., , � ` `
<br /> , -f . .. ,i . •��a 4'
<br /> (` �j:"' . ��. � rxt:,�� -� -�• �t:3� _ � _. .. ..._.....,. - _ ' ,
<br /> drivswaya-Not over Counter if on public,roadways§::neeilSxROW� % . �;'.,,„v,.r h 'µ " ' •- � �
<br /> .. .... . ... .....r. -.., _..,..,... .=.__ .. ,y . , � .., ....,.. ,9 ...,.�
<br />
|