|
�813-7 0-002�1 Gity of Zephyrhills Permit Application Fax-813-78Q-0021
<br /> .t ._,. . .,.,.,. .,�-,_....�,..,,,..Y.._,. � , BuNding[}epartment z_ .r. ...a. ,. .. . .
<br /> /Oate Received; . ` , ,, :,,; ' �Phone Coo�Nac#�for�Ferrrilttin ' . ,. �� _ �
<br /> t
<br /> � --
<br /> Owner's hta�ne - " �t�{✓u�-�;� , � �.e� � t�l"lwner Phone�Plumber. %� �5��'��J�
<br /> Owner's Add s � ! �j' 1�� Qwner Phone Number -
<br /> Fee Slmple Tit eholder Name �� ' � Qwner Rhone Number � �
<br /> r ���
<br /> ,� � ,
<br /> Fee Simple TI ebalder Address `
<br /> JQB ADDRES �� b G��� Al�� - �.aT� �
<br /> SUBDIVI$ION � � PARCEL ID# , .
<br /> . • (OBTAINED FROM PROPERTIF TAX NOTICE)
<br /> WORK PROP� S�p ;.NEW CONS7R ADD/ALT [_� SIGM` C] Q DEMQLiSN
<br /> ��e, INS7ALL 8 REP�AIR -
<br /> PROPOSEQ; SE Q SFR� Q COMM Q �OTHER ,
<br /> TYPE OF GO STRUCTION Q� ' 'BLOCK " Q FRAME 1� , STEEL Q
<br /> DESCRIP"fl0 OF WOFiK ��-�'"Yn 1 � / W� + ��1� `�"
<br /> BUILDI(VCs Sl ��� St�FOOTAGE HEIGHT � � J
<br /> OBU LDING $ � .„/ � �U� VALUATION�`OF TOTAL CONSTRUCTION �
<br /> 5�
<br /> QEL CTRICAL $ e,, �� AMP SERV{CE Q PR�Gi2ESS ENEt2GY Q W.R.E.C.
<br /> QPL�MBlNG �> � -.
<br /> [�M CHANIGA� $ VAI�UATION OF MECtiANtCAt.!PlSTA�.I:ATION
<br /> �
<br /> QG�S Q ROQFING Q SPECIAI_TY C� f Q1'HER�
<br /> FINISH�D F IOOR ELEVATIONS � ��� FLqOD ZONE AREA QYES. NO
<br /> �
<br /> � -�.� ��.�'t"_�
<br /> BUILDEI2 �,,.�,.�.�� � �.�`�'\ � i� CAAIIP�WY��
<br /> SIGNATURE � ��`�- REGISTERED Y/ N FEE cuRRE� Y l N
<br /> Addres Lfcense#'� �
<br /> ELE�7RIC1 -�--ar� •, COMPAPIY' ����"����
<br /> SIGNATURE� REGISTERED Y/ N FEE CURRE�'' `Y/N
<br /> Addres ' License#,� a �
<br /> PLURABER COMPANY
<br /> SIGNA7UR � ` REGISTERED Y./-N F��cuRREn Y/N,
<br /> Addre
<br /> , � � � ,License# � �
<br /> IYIECHA�i1C ` r � COAAP.ANY _
<br /> SIGNATUR '4 ' ' � REGIS7ERED Y_/ N FEE CURREP- Y/�N
<br /> 14ddres .. � . , � � ` ' License#
<br /> O'THER � ' � 'F GOMPAi!IY;
<br /> SIGNATUR � -�`�' `" ^ ' "� � � ' REGISTERED ' �Y/ N.:,.. 'FEE CURRE�', , Y/N
<br /> �►ddre � �� • � � license# 1 �
<br /> h< , y
<br /> RESIDEN __. � �At#2ich(2}oPtof°Plans;,;(2}sets of�Bult'ding�Plar�s;{1}s"'st af Energy Form,s;R=O=W=Pertrilt#or new construo�on,
<br /> � .. ._ ,,.�. ,.
<br /> �..-Minimum�t�rr�(•10):worliing�d"ays�;after,submittal'date.�"Requiretl onsfte,'ConsUuotlbn�Plans;Stormwater'Plans w/Silt Fenae installed,
<br /> Wµ`` Sanl� FaclflUes.�&;,1,dumpsterrSlke aAlorlc3Pemrit fo[su6diyislonsllaige:projects -. ° ' ' ; . < `
<br /> tauY ,... ..t , ,� .;, ,,;,;
<br /> COMNIERC AL Attach(3}-comptete"sets af Buil8ing'P{ans plus a Ltfe�Safeiy Page;(1}set of Energyr Fortns.}2-O W Permit for new oonstru�ton.
<br /> MiMmum ten(10)working days after submfthal date. Requtred onsite,ConstrucNan Plans,$tortnwater Plans w/Silt Fence installsd,
<br /> Sanitary Faclltttes&1 dumpster.Site Work Permit for all naw;projects..AU cammerclal requlrements must meet compliance
<br /> _. .. _
<br /> - -=�iG9V PER 1T AttacFi"(2)sets of`Engiijeer.edcP__.}ans.: . - . � '
<br /> ••'"PROPERTY SURVEY r�quired,far_a!I NEW construcUon. �
<br /> Direc�Qona: , , '- � -
<br /> Ffll ou applicaUon completely.
<br /> Owner&Con#ractor slgn back of appitcaBon,notadzad . _
<br /> �i�ove S2S00,a Notice of Commencement!s required. (NC upgrade�over 5750�).
<br /> '" Agent(for th�e contractor)or Power of Attor'ney'(for tFie owmer)would be sumec�r.a witFe nata_rized letter from owner autharizfng same
<br /> �_ , -
<br /> OVER'THE CQUPITER,PERM1'Ritd� --(Front of�pplication Oniy) •� -
<br /> Reroofs 1f s ingles Sewers Service Upgrades A/C Fenaes(Plot/Survey/Footage) - -- ----� __..
<br /> Drlve ay�-Plot over Counter ff on public roadways:.�eeds ROW -
<br /> � ' J -
<br />
|