|
�
<br /> s��-�eaoa2o City of Zephyrhills Permit Appiication Fax 813-780-0021
<br /> �.._ � , Bultding'Departrnent `
<br /> j .
<br /> Qace rtece�'`v.�a. -.1�,���f� ,� . - r -_ _ _ . .._.r
<br /> • i hans-G�ntact'for�at�tiittin` `" _ ..�.�. - _� .�-.-� -�
<br /> 4wner's Name �� � -� t`I'�i G.a l�-S:,QF ; ` °Cttiiiiter Plione'Nuinber � �' Ct I' ,.�..
<br /> _,. � <s,;..- � �� , .
<br /> � ` _ W...�. _....._�__ �_� ___..����.;.,...- � .,_. „�,��; �
<br /> Owner's Addres� ' `'�, � Owner•Phone Number.
<br /> Fee SMmple�Tltleholder.Name �, �� Owner Phon�Number ,C�
<br /> "--�;;�- - ..� _...H.�, . .. ;�;�.: . �. --��
<br /> Fee'Sfmple Titlehold'erAddresa ° .., . , '' ' �„ �_. ;.':�.. -. _. . ��.� ' .':_.:.,..... �--. __�
<br /> JOB ADDRESS �� $ � � ,; {�.µY4r Yi 1`II S' _-ri(_, �3' Y�LOT# ���
<br /> SUBOIV(SItyN" ' , 'r.,�_'- �`, `PARCEL•ID#� - � _�'`�j-_ .. ,.. ,_,: �.;�:���: :r" �
<br /> � � L , - _ , , „ . ` .,,: , � r.__..,. � , (OBTAINEDFROM�PROPERTYTAX,NOTlCE1; "._... ' '{�,
<br /> WORK PR�POSE4 � . , s NEWCONSTR�. "-'ADDlAi.T' 'S1GN���.� t."=' . . -� � _�''DENiOt;ISH � ,- .
<br /> y� INSTALL 8� .f2EPAIR +��V O�, hY�
<br /> PROS�OSED-USE � Q: ,SFR '[,�� 'CONIM �` ' OTHEI2 ` - -
<br /> TYPE OF CONSTRUCTION� [�'' ,:BLOCK ` .Q.',� '�F ,>,-EI,� . . �_ - , ,
<br /> . . ,a�.. RAME ::C�..., STE ��;:,.._
<br /> � '�f - .` ,. , ...
<br /> DES�CRIPTION OF WORK � S I� f . ,��:. � . �_5;;. ; ,t,,,
<br /> BUti:DtNG��IZE�- .Z��tO �� SQ,FCOTAGE: .ZB�IfO �,HEIGHT . ° �., •
<br /> ,� C .a�.. . d. . _ .
<br />'� �B�'iC�iH�� �_ .. $ �' � ..o,o ., = -_��;::�..:;,:. _ `. -��,::�::. :�: �f ' . . , - -- r...
<br />, . � -��,!,f p� 'VALUATiON`���TC'1'1'AL CONS`I'Rl7CTIQN"" - ,
<br /> QE!?EGTR1CAl $ � .`AMP`SERViCE PROGRESS ENERGY Vy.R.E:C.
<br /> .0 , , .. 0
<br /> ;
<br /> QPLUNIBING $ : , . #3"�`
<br /> i . � � ,-�9� ,,.}
<br /> , QM�CHANtGAL $ VAl{.IATtOtd OF MECNANIGAL iNSTAL�A?If�i+l
<br /> ,
<br /> QG�►S , Q, ROOF.ING�,:Q 3PEG1Ait.TY.�� OTHER . -
<br /> FINISHED F�OOR.Et:EVATIQNS � FLOOD ZONE AREA �YES. NO
<br /> _ �, . , - ..
<br /> ,
<br /> , . ,
<br /> . .. ,
<br /> , _,...
<br /> ____ --
<br /> - -- ---�-;,:. -;i.—--- ... .____ ____-______ _ _ _-_- - - - - -
<br /> -- . _ .__.-�
<br /> -�'8Ui1.DER - - - - - COMPAFtY �
<br /> SIGNA7URE� REGISTERED Y/ N . FEE_CURRE� � �;,YrI.N�_: . • .
<br /> � . _ - .
<br /> Addres� - ' . ` License# t ~ �
<br /> � E�ECTRtC1AN ' , GOMPANY . _ ` ,, �
<br /> SIGNATURE� ` �' REGISTERED Y/ N , FEE GURl3EM Y/.N <
<br /> Addrssa � . F '` ' . ' �
<br /> '`Gr.�n'se�#� ,,,_
<br /> PLUMBER , COMPANY�. :. ... , ,. _
<br /> SIGNATURE . � � ;. �Gis.�REn ;�:;Y/=;N �k � ��E cU�t�n Y/N: ='
<br /> � - . ,
<br /> , �. . � - - s
<br /> :
<br /> .. ,r - - -• .
<br /> �
<br /> Aatlress � , °:License#°.� �
<br /> - - �`
<br /> � ,,...... - ; . . '. - '' � , � _ _ .
<br /> . .. -�:==
<br /> MECHANlCAi: - � ' . :GOMPANY ,
<br /> SIGNATURE� � ; " � ' ` � - �:REGI$TERED. '..YcC.N.- . FEECURRE� ��Y%M:� •
<br /> Addrea's�. � • ...-:� . ,. r , , . Ucense:#y � � _. - `
<br /> I 4'iHER � � - coi�%��i�r -�Y C Y1��n yyt�ert��4 ��`- �
<br /> . �=
<br /> 51GNA'rURE�' ,;.�.. REGIS7ERED Y l-N.. -- .FEE'^U BE� - �Y�' - "
<br /> .,. :.
<br /> , , ,
<br /> `. _ .. ,...., .,:,..._...;.. . '..., , :,... ,,,. . ?-�,.; , , .
<br /> G R /�tJ:<
<br /> Ailare�; :�:'l•�`'-�`.�:� t�;,;��Q��,,O�- ,�}�- 33Sa�, ' ' 'i:iconse-#`: SI��� !2-�.�...' Q' j/�
<br /> .. � ,+.,,�.a - _ :d.4W±,'.t,<n2ua�.>t=y-a„L`'^' ..F.:u:�` - ;S,'s:k�>e:,r x:•• ':�.�"=�!�;:.r::iy;�i:.a._�i.:t.;,,,,., .. .- . ,,.
<br /> RESlDENTIAI:: �==Attactii 2:Plot:'f!lans� setsrof�8`ul!'i!! �Plans� 1 �se#ofiEne t"' �._., -�" „``�.:_. ' _ •
<br /> F'ojin �x.fo +rxi structton,
<br /> r - ( }' ,_�'1)� ng. ,,{ ),'Y- ry`y, s:'Ft=O=lllaFerm,t r.new,i ti
<br /> i � rkin '`da after;.`s �; r,� p,-<. �r.,._<;.., ,,..:.• ,.� `-
<br /> . • � �:t�,Min mum�tien;(t j;vn.o g� ys�_. "if1%mittal daio:�=itequlred`onsite;�GcnstrucBon=Piaris;;Storrr�'waterPlans`w%`SIIt:Fence installed,
<br /> -- -.{� Sanitery Fedittles�&�1,duc�►pster Stteki�to�lc�Pe�rtilE,foc suliidtv�'sion`�tlaige:proieot�';;=:.�=��=;" - ' . ._ . . � -
<br /> COMM�RCIAl. - Atta#�{3)casnp}ete se#s*of,Buitdliig Plar�s plusra�.l:ife-Safety Page:'{'!}set of:Energy,Fotms:R Q-W Petmit`fo�nai��ccnshuc�on:
<br /> �� Minimum ten(10)wafkirig days after submlttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed,
<br /> Senitary Fadlttlas&1.,dumpster.vSite.W.ork Permlt for,all?neuv=pr�jecfs:sAll�commerdat:requtrements�must.meet,compi[ance
<br /> S1GN AERM1' Attai�i 2 sefs of`En"�inee �P �'��,..:. -_'�'- ;.. , . n _ .,. , .
<br /> { �" 9i rei�..tiansq�:� .�,; � � r
<br /> i ""PROP'EF2TY^SURVEY�regulrad',fqr'all NEVV conshucki6n.,_ _ � : • � • .,
<br /> ' — k _ `
<br /> Dlre.�ans; r' �; .� , •,;,__ ,. = .:,,�i,�=, �: ;,.'. _ �. . . � , . , �._I -,,,r ;,.�.,.
<br /> Eflloutapplicatloncor?iplete.ly.= .�� - _,�:, � F;�, . ... -.,, , , �
<br /> Owner&.Contractarr,stgp bactc-of:appltca�lon,notariied ��, . . .. � , t. ,.
<br /> tf ovar'b�500,a.Notice;of..Camr'itencemsnt.i�iequired. ,(NC;upgrades.ovar�7500) - . : .` . " ` - .� . .
<br /> , _:�,�-;�_,,,,���.���c � � ` �
<br /> " Agent(foc.tfie;cant'ractot);ar:Powe�`'of;Atttiiney:(for tFie owner)woultl be someone with natarized letter from owner suthorizing same
<br /> 'DY,ER THE'.CtJ1JNTER;PERMtTTING.�-_ ... (Frorrt of=Appticatiort Only) �
<br /> Reroofs If shingles Sewers •� Servfce Upgrades IVC' Fences(Plat/Survey/Footage) • �•
<br /> Drivewaya-Not over Counter if on pubOc roadwajis.:rieecls�R�W `
<br /> . \
<br />
|