|
tl
<br /> a��-�eo-ooaa City af Zephyrhills Permit Application FeX s�aasaoa2� �
<br /> , Y i Butiding Depa�ttnsnt
<br /> t�
<br /> Date Recefvs�i Phone Co tact for Pe snitt�n -
<br /> Owner"s Namll � � � �v , Qwnsr Phone Nannber
<br /> / � �Owner's Add, ss . I �'�.� Owner Phone Number �
<br /> Fee Slmple TI)Ieholder.Name � � Owner Phane Number r� �
<br /> A'�
<br /> Fee Simple Ti�I�holder Address �
<br /> JOB ADDRESS v � ✓ LOT# �__,��
<br /> � �
<br /> !
<br /> SUSDIWSiO PARCEL ID# �
<br /> „ (OBTAINED FROM,PROPERTYTAX NOTICE}
<br /> WORIC PROPOSED � NEW CON5TR' , ADDIAIT � S1GN �Q [� DEMOL.IBH
<br /> ,e. INSTALL 8 REPAIR �
<br /> PROPC3SE4.U�ISE Q 5FR- Q Ct}MM Q OTHEFt
<br /> TYPE OF CON$TRUCTION' Q � BI.00K '" [_] FRAME STEEL �,]
<br /> DESCRIPTIO� OF WdRK � �' � � / � U J
<br /> II ( -
<br /> BUILDING�Sl� �`SQ�FOOTAGE{�, �. „HEIGHT I
<br /> -.
<br /> ����'�1��' $ J VALUATIONx"tJF TO'fAL CONSTRUCTi . � `�
<br /> �� .
<br /> li QE� CTRICAi. $ ' AMP SERt110E ��1� � PROGRESS ENERGY [� W.R.E.C.
<br /> � — � .
<br /> QFLUMBINti $
<br />'� - � ��r �
<br /> E Q{t+tEGHANlCAL $ YALUATlON OF.MECNIWICAI.INSTALLATION.
<br /> i ( .. -
<br /> 'k C]��S 0 aooF�N� _0 sp�cx�.�r � 01'HfR -
<br /> � FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA �YES NO
<br /> I
<br /> ; BtlI�D�l3 � GOMPANY` `
<br /> SIGNATUREi REGISTERED Y/ N �eE curt�n ' Y/N _�
<br /> j Addrea� � , �L:lcense�#
<br /> `
<br /> �� �t�c�c�.' t�� t -coM�,a� �' _ ' � U r� l;
<br /> SIGNATURE� �' � �� REGI3TERED Y/ N FEE CURRE�` Y/N
<br /> Addre� - _ . � License# � . � �
<br /> I PLUNIBER '� - COMRANY ,
<br /> � SIGNA"I'URE� ' REGISTERED Y./:N: . �Ee cu�En ' Y-/N. -
<br /> I Addre � License,# � -�
<br /> MECNAPIIC ' ", _ � COM,P,ANY . . ,
<br /> SIGNATURE� � � REGISTERED Y,/ N FEE CURRE� Y/-N
<br /> Addrss� ' � AF J� - ` - � � License#
<br /> OTHER � � ',COMPANit, ,
<br /> SIGNATURE °- � `' `' ` � ' REGISTEREyD ' Y/ N . FEE CURREh Y/N
<br /> Addr � .. l . _ ' _ � "licerise# �� �
<br /> i
<br /> RESIQEN _�� �.f : �Attacti'{2)APIo#%P-,lans;<(2)§efs_.ofiBulliling�Plao's;`(1}'set af'Energy=Forms;`'R=0-W Perisilt far new cxinstruaUan, '
<br /> � � MinlmumNten,(,1,0);worlcing;daygyafter.:submittafdafe.'�:Requlred onsite;:Constrtrcdon'P..Ians;Stortnwater Plans w/Sllt Fence installed,
<br /> . ������ �Sanitary Facllidess&;1;,dumpste,r,-$Ite-Wo►1c,,Permif;far subdlvislons/iarge projects;,.'�h_;._,. ' - � �
<br /> COMMERCld41. Attach{3}�oainptete's�#s of Building�Plans pius a Llfe Safefy Page;{1)set af Energy Faims.R-O=W Perrt�it for neuv construc�#3on.
<br /> Minimum ten(10)wartcing�days afke�subirilkhalFdate: Required onsite,CanstrucNan Plane,��Storitiwater Plans�w/Silt Fence instatled,
<br /> Sanitary Facilitles 8�1 dumpste�.Site Work Permtt for all new projects:All commercial requlrements must meet compliance
<br /> St�N PERM T Attacti{2}sets of Eriglneer.ied�Plaris.,:� ��.^ - � , -
<br /> i ""'PROPERTY SURVEY reGutred for aII,IVEW constructlbn.
<br /> Dlrectlo�s:�) ;� , �
<br /> Ffll out;applicaHon completely.
<br /> Owner!�Contrector stgn back of applfcaUan,natadzed
<br /> if aver;3�500.a NoUce of Commencement la rfequired. (AlC upgrades over 57500)
<br /> :;,.:::.::� ,,:, :, � _.
<br /> ... _
<br /> '" Agent(for the cantractor)'or Powe�of Atfarney(for�tFie ovimer)would be someone with notarized letter from owner authorizing same
<br /> t�VER THE��OUNTER PERMiT'i1NG ..__,.(Front af•AAPiication O�ly}-
<br /> Reroofs if s�ngles Sewers Service Upgrades A/G Fences(PIoUSurvey/Footage)
<br /> Drivew ya•Rtat over Counter if an public rasdways..needs R(3W
<br /> I I
<br /> �
<br /> � f ---- - -
<br />
|