|
� r
<br /> �,i e�isaoa2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> s'
<br /> � � 8uflding Department
<br /> F
<br /> � '
<br /> i
<br /> Dale Received .� ' � . P.,hone=Cantactfar�Perml�Eln ,
<br /> ; �,
<br /> Owner's Namle � Owner P�ane Nurobe �61.� Zl �
<br /> - �y, ., _••
<br /> �� , , `
<br /> Owner's Addrass t'.� � c9 � C�- 33 �J pyvner Phone Plumber , j
<br /> Fee Simple T�tleholder Name �� Owner Phone Number � �
<br /> Fee Stmple Tltlehalder Addcesa c'� d. ,f,fl � --~' -. �,
<br /> � ` ��JOB ADDRE�S , G LOT# J V
<br /> St7BDtViSIQNI `! - PARCEt,ID# ��-�_ � r'�t>�7 ( O �O �,''�.•--d��'+ �o
<br /> I (OBTAINED F,RpM PROPERTY,TAX NOTICE)
<br /> WORK PR4POSE0- �. NEW CONSTR � - ADDIAI.T C,� SIGN C] �Q DEMQLiSH
<br /> INSTAI.,L REPAIR �
<br /> PRQF08EDF�$E Q SFR � GOMM �� OTHER I
<br /> TYPE OF CONSTRUCTION Q` BLOCK '' `[� FRAME � STEEL Q
<br /> DE3CRIPTION dF WORK, -;-. ..� t.�G.� � -- � ',� aa c���,t
<br /> .:, t
<br /> BUII.DING�IZE (.� ,,,, ��8Q FOOTAGE �� , HEIt3HT .[^���� �
<br /> QBUILDING $ VAGUATtON'OF'Tt31'Al COIVSTRI)CTION '
<br /> ���` �
<br /> i
<br /> QEC.ECTRIGAI $ r ,,��_ AMP SERVECE Q PFtOGRESS ENERGY Q W.R.E.C. ,O
<br /> QPLUMBlNG $ ...� � '—'" �L b 7�� �'.. �
<br /> �.�' , '� \
<br /> Q M CHANlCAL $� � ' VAi:UATIQN QF;MECHANICAL lNSi"A�LATtON. � �`f���' '"�
<br /> � �- . . � �
<br /> Q�S [� ROOFING Q SPECIAI.TY �� OTHER ��p a�'�
<br /> 1
<br /> FI�fISHED FI.00R ELEVATIONS FLOOD ZONE AREA QYES . � ,. ?��
<br /> Jv
<br /> But�.oE� �! - t� � �
<br /> � oM Atav� � 6 r.e:� G, � � `1
<br /> SiGNATURE REGISTERED / N FEE CURREP �,Y/N �
<br /> Address Ltcense# �— �� .
<br /> ELECTRlCl�1N. .- ` :COMPANY ' - �
<br /> SIGNATUREI� '' REGISTERED Y/ N FEE CURREk� Y/N �
<br /> i
<br /> Aaa�ss , � , uce�se# - ` '
<br /> PLUMBER i CCIMPANY �
<br /> StGNATURE " ' � REGISTERED Y./-N�_ . FEE CURRE� � � ' Y-/N �
<br /> Addrese � . ' Ucense.# �� � {
<br /> �
<br /> MECNANlGAL" , . . _ COMP.AFIY
<br /> SiGNATURE � � � ` t3eG�s7ErteD Y./ N . � Fee cuw�n Y/�N
<br /> Addre�s ` ,•' ',. . � .. _ _ ,
<br /> License# � �
<br /> OTNER - _.. .iCOMPANY � ,
<br /> SiGNA7URE� ,'.�' . '"� '"� ' " ' �- -' ' � ` � " �" REGISTERED ' `Y/ N..- FEE CURREh Y/N
<br /> Address ' , ` . � . Cicetise# f'' ' 1 -
<br /> �
<br /> ,... ,,.;., . ._ ,-. .,._ �
<br /> -- . , , • ,,. ,, f. . .
<br /> ��s�a��r� > -- �tra�:�z����ot�Pla�s;R fi2)set's:of�BulldingF Plans;(1)set'of=Enerc,}y�Fortns;;R-O W,Perir�it for new consbuct�on, ,
<br /> ,._;
<br /> ;-T:Mtnimum:ien_(:1.0);working days;after;subinittal`d'afe:.Required onsite;;ConstrucNon-Pl�ans;Stormweter'Plans w/Sflt Fence�installed, �
<br /> ` ��-�Sanitery FacillUas,&a,1,�;dumpste_r,�Stte,Waric:Permit fcr.subdivislo�s/large pro)ects, ' � - `- � � �
<br /> COMMERClAt. At#ach(3)coinpiete sets'of Bultdiiig Plaiis'plus a.Clfe Safefy Page;�('!a sei of Eriergy Fotrns,i2-O-W Permlt far newi cans#rvctlan.
<br /> Minimum ten(10)working days'afler submittal date. Requlred onsite,CanstrucNon Plans,Stornnwater Plans w/Silt Fence installed,
<br /> � Sanitary Facllides 8�1 dumpster.Site Work Permit for all naw:proJects.All commerctal requlrements.must meet c�ompliance�
<br /> Sl�N PERMIT Attadti(2}'sets'of"Erigliieered�Plans.t;�. ,�~ .- : , . . �
<br /> � '""PROPERTY SURVEY reyuired,for all NEW.construcUon. ,
<br /> Direcllons: , .-. . - � •
<br /> Ffll out a�plicatlan completely. �
<br /> Qwner d�Contractoc sign back of appl[caUon,nptarized � ,
<br /> If over tti2600,,a Na�ce of Commencemen#is reguired. {AtC upgrades over�7500)
<br /> " Agent(for the contractor)'or"Power of Atkomey�(for tFi'e.owner)�wrould be someane with notarized letter from owner authorizing same
<br /> VER'TiiE G�OUNTER PERMITiiNG..a.•- ;:{Fronfiof:flppllcatlan-Only} -��,5�., "�u, .
<br /> afs if shi�gles Sewers' Service Upgrades A/C Fences(PIoU,Survey/Foatage)
<br /> , .. ,
<br /> ivew lya-Not over Caunter if on publia roadways..needs ROW' � N
<br /> . �
<br />
|