|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> . Building Department �
<br /> � •-
<br /> Date Recelved " phone•Conf�ct for-�Permlttln '�' �•O I 3 ���� -UJv_I �Xt•���..
<br /> Owner's Name Q��I� � �f 5 Owner Phone Number U��-�3►a-3��I
<br /> Owner's Address � �3� `l,� f"I�, �h1��.S 3� Owner�Phon�Ndmber � ' '
<br /> Fee Slmple TltleholderName ' • Owner Phone'Nu'nber �
<br /> Fee Simple Tttleholder Addresa • u
<br /> JOB I�DDRESS � l�3� ' !�� Je. �h� II s �I 3 35 a � �oT# �
<br /> SUBDIVISION ' PARCEL ID# - � '
<br /> (OBTAINED FROM PROPERTY:TAX NOTICE)
<br /> WORK PROPOSED� NEW CONSTR' ADD/AL'P - Q` SIGN� Q •Q DEMOLISH
<br /> , e_n. INSTALL �B ', REPAIR: - � , .
<br /> PROPOSED>.USE -;_�a- Q SFR Q� COMM ' Q - •OTHER E= 4 - �
<br /> TYPE OF CONSTRUCTION � Q ` BLOCK' ` Q FRAME ,. [� " 'STEEC " 'Q � _
<br /> DESCRIPTION OF WORK� eC�r O� �e-roo� ._]g �ar e s 0•C� as I�a.P+ 5 h�n�IC'S
<br /> BUILDING SIZE' � � 'SQ FOOTAGE.�; ;. , .,HEI.GHT�� .. • �
<br /> QBUILDING $ ��� �- VAI:UATION�"OF',•TOl'AL'COyS�RUCTION�53�5" ' '
<br /> QELECTRICAL $ • � • �AMPSERVICE �""Q PROGRESS�ENERGY Q W:R.E.C.
<br /> . ,� -
<br /> QPLUMBING "$ - � � `�C�W�
<br /> , �
<br /> [�MECHANICAL $ VALUATION.OF;MECHAfVICAL INSTALLATION.
<br /> QGAS , •Q ROOFING :Q SPECIALI'Y..Q :. OTHER� . _
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO
<br /> BUILDER COMPANY' ` � � _ . . . -- �
<br /> SIGNATURE REGISTERED Y/ N � �FEE CURREK �'Y/N�
<br /> Address ; - -, , � License#�
<br /> ELECTRICIAN; - - � - " 'COMPANY ' - " - . . - _
<br /> SIGNATURE ' ' REGISTERED Y/ N F�:Cu�n�' ' `.'<�Y�/•N'• ` ' �
<br /> Addresa - . ' ... . .. License;# ��.
<br /> PLUMBER C.OMPANY: � :. . :T: •t.�, .::: ., • '
<br /> w,,.,.
<br /> SIGNATURE'"` � , ; .REGISTERED. Y:/-.N.,;. : =,:FEECU.RFtE�; :Y•LN.
<br /> Address � ., _ �,'ycense,#,� . , : � � ..
<br /> , . , . . ,,..r�; «• ,
<br /> MECHANICAI: . � � � � � �COMPANIY � . . -� . ,
<br /> - �..��... .
<br /> SIGNATURE• � � ` � ' RE�isTEReD Y.:L:N. . : „ Fe�Cur�En... : . Y:/N' _
<br /> Address' _ - :`- ` . • ' � • � � � � . License#� -
<br /> OTHER . ' �D . . - :.COMPANY C4� (�U�:�.. ..�' . �
<br /> SIGNATURE' .. '`^�" ��' ��� � REGIS7ER�� � - Y/ N:.� �`FEE CUR � Y/N
<br /> _ . ,. . I i . , .
<br /> Addresg� :��. •�-�;:5�...,5. :,.�y � h::f_!��I l-. � �3Sy) . .� u��se# CC�3�55t�S � _ -
<br /> F ' _'"� � ' �. -F'.�t' � . ;',;yr�. . : •
<br /> RESIDENTIAL;',;�::�Atta;cli'(2)„PIot�Plans';;(2)sets;of�Buildfng:Plans;`(1)'"seE;of�Eriergy=Foirns;R-O=W�Pertnlffor.newconsfruction, _ � ''
<br /> - _., .. .. . .. . ..
<br /> ...;�.,_ � � . � .. , _ � ,:, . -_ . , _ . , . _ , ,�
<br /> �,;:Minimum�ten;(.1A�;uyqricing2deys_;after„submittal'date:,`Required'on`s'ife,�:�onstiuctlon�`Plans;`StortnwaterPlenswfSllt=Fencelnstalled, °
<br /> �"�Senifery Fadlldes;&;1�dumpster-,Site=Work:Permitfor;subdiv,islonsAarge.pr_'ojects.,'•�';_.r�;,�:: _ _ , �
<br /> COfNMERCiAL Attach(3)roomplete sets of�Building Plans plus a Life Safety Page;�(1)set of Energy Forms.R O-W Permit for nevit construcUon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Fadlides_&�1 dumpster..Sita Work Permit for all nevrproJects.:All commercial,requirements must meet campllance •
<br /> SIGNPERMIT Attach(2).'sets�of�Engineer,ed;P::lans::..�:.,3�,�-; -_. =- - ��' '
<br /> ••••PROPERT.Y.SURVEY recjuired fur all NEW:consWctlon. � . - ' • � ` •• •- � - - .
<br /> Dlrecdons: ,._ • - - � � . . -.
<br /> FIII out applfcadon campletely.
<br /> Owner 8 Contractor sigm back of applicatlon,notarized "
<br /> If over 52500,.a;Notice of,Commencement is requlred. (AlC upgrades�ovec$T500) _ . „`� - �, ' = � .
<br /> :...., ,,,_:�..,.: > � � ,
<br /> �w �-'..e.:r`}„�:�
<br /> Agent(for the�contractor)or'Power of Attomey(for tFie ovmer)would be someone with notarized letter from owner authorizing same
<br /> - : ;: ...�... , �t:.
<br /> DVER THE,CQUNTER�E�,M�T�NS',T;,�„„,,;,�;,(Front'of•AppllcaUomOnly)--"�- ' �� ���`' �
<br /> Reroots if�shingles �;4`$eweF's"�-- ;$eivice Upgrades WC Fences'(Plot/Survey/Footage)
<br /> �� �'s t�<,, ., , i ._ � . -,�d,: �• ;g .:i: - � - , � - , - , _ � --- _---—• ---���p .. `_u`
<br /> �? Dridewajra-Not over,Counter:iFe���p,utilic�yy'roadways:.needs ROW' j.,}-� -�,;�,_ . '•,�s '���� ,__i.�}� � �� t(�
<br /> �� . .��v��i .i+:. "�SL'L ��^-.:�a.e.' �� 4� ,�ti�a�i� ,�i,:? 1! ,..- l��� „ i r,`..:i,'/' . :F�
<br /> ,�'.�_.. ........... .. .... .ti+-.. "'-'- .'—_ _. .._ `�� , ,�.. „ .,�.,� � : i � • - ��iql��I+'�.�
<br /> w.a�.+K.s,M�r•.•ti:.... .w.. <,.i..-wa�•.iy.nq.w+a.---,R,,,,, ' ;�,. 1: _
<br /> e'�' ' .�:�ar»....�Vw:}r:t�,ir.�,�°:reo,:w...+ur.`w,.r..�•�
<br /> 4..;:e..u. .._a.a.
<br />
|