|
,
<br /> � e��-?ao-ooaa City af Zephyrhills Permit Application Fax-813-780-Q021
<br /> r � � BuNding Department _
<br /> � -�, - .
<br /> Date Recelysd ' � Phone�Contactfor.PerrtiitEtn �
<br /> Owner's Mame o�C.s � � � �!>C� Owner Phane Number U ������JS
<br /> Owner's Address � b/ �e /�i ! . '+� Owner Phone Number �— �
<br /> Fee Slmple Yitfeholder Nama � � Owner Phone Number ��� �
<br /> , Fee Simple Titleholder Address
<br /> � , � r
<br /> � / JOB ADDRESS � ��I .�rll r" �A- - �C�' L G S / ,� LOT�R ��
<br /> suso�v�s�or� � .� e�p�` � 1�//PaRce��a# . ID � ,�`�j t.�/�.A t3L�1�1S D�'�'1
<br /> (OBTAINED F,RdM.PROPERT1f TAX NOTICE)
<br /> WORK PitOPOSED_ �,�Ew'CONSTR . ADQlAi:T �� SiGN Q Q DEMOLtSH
<br /> �.e, INSTALL REPAIR
<br /> PROPOSED�USE � Q SFR� [� COMM Q - C?TtiER
<br /> TYPE OF CQNSTRUGTION � Q ' BLOCK ' [� FRANIE [�] STEEL Q
<br /> DESCRIPTIQN O�WORK J ��� � �(31V �`� b�/1"2 aC. �l.?7`� ���5
<br /> BtItLDING SlZE` � � � SQ FOOTAGE��-� HEIGi�iT 'C��
<br /> �$������' L , � VA�UATION`C)F1'O'i'10.LCOi�BTF�UGT'IOIV
<br /> • �
<br /> QE�ECTE2IGAL ., -� � AMP SERVIGE Q PR{�GRESS ENERGY Q W.Ft.E.C.
<br /> QPLUMBlNG �� � ^
<br /> QMECHi�WICAL $ ���� VALCIATlON OF'MECHRNICAI!{�lSTALLATION
<br /> �_`��„ o ,�- �
<br /> QGAS [J EZOOFiNG Q SPEC1AlTY � OTHER
<br /> FINISHED FLOOR ELEVATiQNS ��� FI.00D ZQNE AREA QYES. NO
<br /> BtI1l.DER COMPANY� .
<br /> SIGNATURE REGISTERED Y/ nl FEE CURRE� ` Y/N
<br /> Address � - Ltcense# ( �
<br /> EtECTRICIAN:. - . ,'COMPANY � -_ .
<br /> SIGNATURE � REGISTERED Y/ N FEE�CURREN= ' ''Y/N�
<br /> AR3dress � . , ., n Licanse#..� • �
<br /> PLUMBER � COlNDPAHY . ,
<br /> SIGNATURE .� _' :,' :: . . , , : � .
<br /> � ; ,REGISTERED r ,Y./>.N>j �. ,FEE-CURRE� --•- Y/N.
<br /> Address � ,. .llcense,# 1.-_. -.... �� , . ,� 1
<br /> � ��/� , �/
<br /> MECHANlCAR:' _.� GOMPAN1l- �t�?l�'lEi�i� S j� ��, ��{V�,°i
<br /> ) �;.-:.
<br /> SIGWA7URE � � 'G���%"i'�h-- .` �Gis7ERea ....Y../ N . , �E Cuat�n- Y./�N� •
<br /> � . . -. . � .z.
<br /> . � - j/� �``�
<br /> ,- . �.. .,:
<br /> ,.;.. -7'�7! '�/'7 �N` ' �� s . �.. _ license#� C�l"r'G� 7.c'��"T^t�- 1
<br /> Address ° - _
<br /> ' ' . , _� .. .. . � • . , _ .
<br /> O'fHER � r , , - _ ;CONIPANY � ....
<br /> SIGNATURE a � ` " � �`' � ' ' �REGISTERED{ ' , Y/ N.,.. ' FeE cui�n _ Y 7.N.
<br /> Addres� � , - . ., . _ h„ • � ` � . ' ' � Cicanse# �` 1
<br /> � _ . .�,.;:, - � ,. . . :. r - � .
<br /> RESIDENTIAL.,c; Attacti;(2)�Plct�P1ans;�(2)sets.of�8u1lding!P.laizs;(1j sef of=Energy�Forins,"R-0=Vit`Peliziit for'nsw consttuction, �..
<br /> - .�; Mintmum}ken{(41.0),�worlcing�days;after,:submlttal date.::Required onslte;�ConstiucBon Pians;Stomnwater Plans�w%Sflt Fence instai�ed,
<br /> . " `" SanitaryFaclltdess&=.1rdw�mqste,r,.�S(te°alVorlc;jPermit;fgrsu6diyisions/large',-projects ,__', � " ' , `
<br /> GOMMERCIAI. Attech{3}�coinpiate seCs�of 8aliiitrig Plaris pius a l.ife Safety Page;{1}set of Energy Farms.R-U-W petmit for new construcUdn.. _ __
<br /> Minfmum ten(10)working days after submitfal date. Required onsite,�CanstrucUon Plans;Stormwater Plans wi Silt Fence installed,
<br /> Sanitary Facilides 8�1 dumpster.Site Work Permit tor all new;,projects..All commercial rerqulrements.must meet compllance
<br /> SIfiN PERMIT Attadi"{2)'sets�of`Eiiglneer;edcPtans:. ,,,,.�:�:- � r , . � �
<br /> •"'•PROPERTY BURVEY reyuired,for all NEW,constructian.. - � _
<br /> - - - - , i
<br /> Dlrections: ,-�� ... , - ��
<br /> Fill out applicatlon completely.
<br /> Owner&Contractor slgn back of appficatlan,natarized
<br /> If over y260d,a Notice af Commencement is reqaired. {AtC upgrades aver ST500)
<br /> .. a'-�:.+;,>:-;n,�a;.�
<br /> AgeM(for the contractor)or`Powe�'of Attomey(Wr tFie�owner)�would be someone with notarized letter from owner authorizing same
<br /> _._ - , - �,�..
<br /> OVERTWECOUNTER:REttMlTTiNG...,;==�`:{Ftoiitof.ApPlication;Orily}-.,.;:.,��< �.� „ ,
<br /> Reroofs if shingles Sewers S,ervice Upgrad,`es A1C;;;:;;, Fences(PlodSurvey/Foatage) . .. w„_
<br /> _ �_,..., ......_ _.:r. .�-- " �,�.�. ..,,__ -�'a.. . .. . :,�m,,r,:
<br /> r�.,.
<br /> Drivewaya-Not over Caunter if on publfc;roadway`s,;:neec�s,ROW- ,
<br /> �. � .� .�.. ,.�, ..,,w,. ��. . . ...,. .
<br />
|