|
t � _ - _ _ _____ .
<br /> I
<br /> 81;3-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> J � Butiding Depattmen#
<br /> Dats Etaceiv�ed ' 'P,hane=Cantact�far Permtttin
<br /> Owner's Nalelt�e � � � � Owner Phone Number
<br /> Owner's Address C.. I Owrner Phone-Number �- �
<br /> � ,
<br /> Fee Simple 7'Itlefiolder Name `� � � Owner Phone Number �� �
<br /> I
<br /> Fee Slmple Titleholder Address
<br /> ! �JOB ADDR�SS � � � LOT#
<br /> SUBDIViStON , �� � RARCEL ID#
<br /> I , � „ (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROI OSED � NEW CONSTR ADDtPiLT �" S1Gfi!' [� Q DEMO�ISH
<br /> INSTALL � , REPAIR
<br /> FROPC}SED)USE Q S�R Q CQMM �� OTHER
<br /> TYPE OF C �NSTRUCTION Q�' ' BL.00K '' [� FRAME [�� STEEL [�
<br /> DESCRtPTIQN OF WORK ^ � C� �� ,� [
<br /> i
<br /> Bi!lLDf�IG'�IZE �� �"SQ FOOTAGE � HEIGHT .{�,�
<br /> QB'�Ii,DING $ +VALUATIO(V'OF TOTAI CONSTf2UCTION
<br />' QE I CTRICAL $ ' AMP SERVICE Q PROGRESS ENEFtGl' Q W.f2.E.C.
<br /> QPLUM8ING $ _ �
<br /> f
<br /> I - � I
<br /> M�CHANICAL $ � �VALUATlON OF,11r1ECHANICAI ENSTALLATIt�N_ I'
<br /> �I , �
<br /> � I � ��`�� 7 1
<br /> Q�S Q ROOFING .Q , SPEGIAI.TY �� Ol'HER
<br /> ' FINISHED F OOR ELEVATIQNS FLOOD ZONE AREA QYES NO
<br /> ' _ .} i
<br /> i ,
<br /> BU1I.DER COt1IIPA�tY �
<br /> SIGNATURE REGISTEREd Y/ N FEE CURRE� Y'/N
<br /> i Addres � � • �License,#'( � ��
<br /> , . ..-
<br /> E�ECTRICI. -COMptWY . --
<br /> i SIGNATURE '� REGISTERED Y/ N FEE CURRE�- � Y/N (i
<br /> � Acldress - - � . - - � , � License# i �.
<br /> i � • � i
<br /> . , ' �
<br /> I� PLUMBElt ° C.OMP.,ANY � :� ,
<br /> SIGNATURE' REGISTERED Y/ N.. .FEE CURREP � Y-/N
<br /> I _ , , � .
<br /> � Address � Llcense,# [ _ . �
<br /> �� r �
<br /> � �MECHANIGAL y�����` " � CQMPMlY 1d r� �r .
<br /> SIGNA7URE ' ' ^' i ' REGISI'ERED Y,/ FEE RR,P Y./-N
<br /> 'I , i - � p l �
<br /> Address � �c� e "�. � �,� License# �� /�t �. �
<br /> ,. _ ,. -
<br /> OTFiER - . .. ' - ` ";GOMPANY �
<br /> SIGNATURE '_ -- - •� � � � REGISTERED ` Y/ N;. ' FEE CURREh Y/N
<br /> Add(988! .. ,. � Y ' LtciBtts9#'� �
<br /> i
<br /> 'itHii+hFFhK . , , , .
<br /> �:..
<br /> RESIDENTlAl.; •Attacti-(2}aRtofr Pla�s;(2}sets=`_of.{Bu1181og�Flaiis;'(4)set afi Erie'rgy>Forms;R-O-W'Permlt for new canstrucUan,
<br /> �� Minimum�ten-_(-1.0),woricing days:after submittal'date.��.Requlred onsite;:CionstnicNon Plans;Stormwater"Pians w!Si1t Fence instailed,
<br /> ��� Sanlfery�FaGiftles.&t1=,dumpste_r;.Site�Wor{ciPertnit;forsubd1yi51ons/large proJects,,.`- :1,.. � � '` .
<br /> GOMMERCIA�.- A#tach{3)�coiirplefe'sef's of BuElding Piaris plus a.Cife S�afety Page;��1 j�et of Energy Farms.R-O W Permlt for neuv constructlon:
<br /> Minimum#en(10)working days after submittal date. Requlred onsite,Canstruction Plans,Stormwater Plans w/Sllt Fence installed,
<br /> � Sanitary Facilitles 8 1 dumpster.Site Work Permit for all new projects..All commercial requlrements.must meet compllance � �
<br /> SIGN PERtV11T Att�cc�i{2j sets of"�ngirie�ec+ed:Plan's_...= �a� •- ��: ,>-- - _ .
<br /> .««.PROPERTY SURVEY reguired,for ali NEW canstructlon.
<br /> Directlons: .:,•,..• � _
<br /> FIII out ap�plicatlon completely.
<br /> Owner&�Contractor slgn back of appltcaSan,notarized
<br /> tf over��500,a NoNce af Cammencemecrt 1�e�qui�ad. {AtC upgrades over 57500j
<br /> � < .�:�,.;�.._�;,,..
<br /> " Agent(fo�the�contractor)or"PoV�ier of Attorriey�(for tFie awner)wrould be someone writh notarized letter from owner authorizing same
<br /> OVER THE C�UNTER PERM11'TiNG - -- {Front af AppllcatEon Only} �-
<br /> Reroofs if shingles Sewers Seroice Upgrades A/C Fences(Plot/Survey/Footag"e)
<br /> Drivewaj� -hMt aver Counter if on pubtic roadways..rtieed's ROW
<br /> i �
<br /> ( -
<br />
|