|
_-_i _ ____ -
<br /> ! (
<br /> s',�-7eo-oozo City of Zephyrhills Permit Application Fa�t 813-7$(�0021
<br /> 8uilding Deparfinent
<br /> vC ` �i -• . �
<br /> Date Rscei ed ° � 7. � � � ' ',
<br /> ii � � -�``Rhcne�Goatact�fcr'�Paranittlr��'�.� � .
<br /> Owner's Nalme { � pwner Phone Number �
<br /> Owner's�dress � �'� P .,P /�'1 i �����ivvnerPhone Numbsr � �
<br /> : i �1��� .
<br /> Fee Simpl�TlNeholder•Name � � Owner Phone Number "
<br /> � ��, . , � � ' - -��
<br /> Fee 8lmple�7ltleholder Add�ess �9 s
<br /> JO�,4DDRESS C. C� ' Ct, V - - LQT# �_��
<br />�i SUBDiVISI l N - � . �. P14RCEL'ID# " ~ � �ll K�. /
<br /> � � . . - � - •(OBTAINED'FROM'PROP T NOTIGE) _• �
<br /> WORK AR�POSED NEw GdNSTR ` ADD/AI:T ��" SiGN "[,� Q, DEMOL'iSH .
<br /> .. � e INS7'AI:L 8'-�� =REPAIR' '
<br /> PttOPOSE�USE- Q"� "SFR �Q COMPttI' �� OTIiEi2' .a
<br /> TYPE OF C N3TRWCTION;; Q' '�BLOCK'�' ,Q . FRAME � STEEL ,Q.,
<br /> DESCItIPTI�N OF�WORK - t ' !' -
<br /> / D/1 �/� %J ��.`7,
<br /> BUN»Dft�G�itZE;�' � $Q FQUTAGE;. i : HEIGii� . : ' " '
<br /> . QB I�DiPtG $ y �,.,�;��.s� .,..,r rn ' - -
<br /> �� �� VAI.UATION`�F 70TAL'CONSTRUCTION . _. , _
<br /> QEI.ECTRICAt. $ AMP��RVICE - - ' PROGRESS E(VERGY W.R.E.C. �4
<br /> 0 0
<br /> . _ _ , -�
<br /> I QP�RUM81CdG �$` � � �
<br /> I � . � - . ���'' -
<br /> ` IECHRNIC,4L $ � NAI.tli4TEON OF MEGHANtCAL.INSTAILATlOi�! �
<br /> - `� , �..
<br /> GAS [� ROQFlNG.,,C,] - SPECIALTY�'Q OTHER� -
<br /> FINISHED�LOOR ELEVATIONS FLOOD ZONE AREA �YES. NO
<br /> � � .. -
<br /> �
<br /> BUIk.DER COMPANY� ': ,
<br /> SIGNATUR� REOISTERED Y/ N �E Cuw�e�:, Y L.N_. . ,
<br /> i
<br /> Addre�� .� � - • , ,Llcense`# � � �
<br /> ���4 tNY�"fi•`' ' ' qy r:`4V�rIV�[ .r.�:. " � _ ' .
<br /> SIGNATUR� y REGISTERED Y/ N FEE CURREK Y/N _
<br /> Acidres� _ :L°icense#�� -
<br /> PLUMBER CONIPANY� ' ' _ � `,
<br /> SIGNATUR " " � .r�c�is,��o. �,vY/-.N F�:cuwzen� 'Y/.N:
<br /> ( .�� � , ,- _, • . - - . _, .
<br /> Addre� , Ucense#� ` ' �
<br /> .�
<br /> I . , ... ,- �: t� ` /�
<br /> MECliAA�!!�A[:, � . �GC1MPqNY ./� I �� t (.�. t�
<br /> _ . .,:
<br /> SIGNATUR ` ` � REGIS7ERED� Y;/: .,.FEE CURREk; °Y/-N:, •
<br /> �ddres� .. :i� � : �t i `�., � l:lcdnse# � -"
<br /> - ' - . . .. : - ;.. . , , , .
<br /> o�t�R ' �.��;� __. �. ,.-._,. _ � ;coM�ai�nr. . � ,.: :; �. �...-. ..,. :..... .
<br /> f.�,,
<br /> SICiNATUR � � -� - '` ' � ' � � � _ -REGIS7ERED_ _ Y/ N�.. - F.E�CURi3E�� Y/�N:� .
<br /> Addrs I a . . ,(.��,;:f' .... � . .�- .� _ .. - , .. ,'..� ,�;. }; . _ `
<br /> i
<br /> 'L`I�ense'#�
<br /> � . , : - � '.: .. 4, " ' ' ..". ��.. "'�.�_. �,..}.,t_ .,..,'.e t:,:., -t.Kg,�' ' ��� ,, � � � . . " .
<br /> �� _.. �, ��. . . . .• - .'.' �,.;. , .-' �'_� .....-•c �::t-,::
<br /> RESIpE - �.Attactt�{2)aPCot�P.,lans;=(�}:sets.oft8ui!`dl"rig�Plans;.{1}sefof.�Enargyr�Foriris:'R0=Vi1`Reririltfotnsvir:constnic�,on,. -- .
<br /> �� � .:,Mlnimum+tens(1Q.)�woriting;days�.:,a(te'i:"sutimltfal�tlafec�Requlred.`o"nsite;-Construcdon;Plains�:Stormwreter�Plansw/`SIItEence.Instalied,
<br /> � �,,;..Sanitarjt Faci�Ities 8���f,tlur�tpsterjSite��lVorlc�P.,erm12 foG.sci6dljri'slOris7targe prqjects',::'A;�aY::`��s.;:::" ° . .. .= _ .; _ ' - ,
<br /> C��R�fiERC1 Atiach{3)'complete'se'ts"of Biiltdlrig Pietts plos a�[fe Safety Page,'(1}set of Energy Forms.R t3-W Permit for nevV catistrucflon.
<br /> R � � . •
<br /> Minimum ten(14)woricing days after submittal date. Requlred onslte,�Constructlon Plans,Stormwater Plans w/Sllt Fence installed,
<br /> � 9anitary,Fadlitles 8�.1_dumpster..S[te-Work.Permlt,for alUnew'proj�cts;�All`cammerclaGnequl�ements�mu�t meet comp!lance
<br /> _re.:�,.h:.:. ::.�:r�:�-� "s.` , .
<br /> ,IGN:PERM17 Attacti(2)s"'ets tif`Engtiiiaeied=.F?laiis;�;�a,�;:r;`..�, ,:. - .:~,�.`. ,
<br /> II """PROPERTY.BURVEY r�equired;for�all;NEW,c�ns.truction...�. :.._ � � " � �
<br /> :.���.....;_,�— �. . ,, , _ , -� � ,
<br /> Dlrectlons: �� .. ., .� -. - - .. - _- . .
<br /> Flil.out applicatlon completely.
<br /> t?wner�Cantractor sign back�of appitcatloo,notariz�i
<br /> tf ov�r$2500;a;Nottce of.Commencement i's requiced. (AIC upgradss over-$75G0),,,_ �, -
<br /> �� �I �vi[2�.oa'v:;�...:_{<Ei'r:Yr.'.r' ._ ,..��,...._.r..
<br /> Ayent(�r ttie contractcir)'or'Power of Attertiey(forthe'owner)would be scmeone with nota�ized.letter fram owner autho�izing same
<br /> O.V,ER THE C�OUNTER.PERMITTING�= -. •�{Froi►t<of�Appllcatio'n'Onlyi) � � v - ; �
<br /> Reroofs If shii�gles +. ^ Sewers' _ Servlca Upgredes='AIC:--,.:Fences(Plot/Survey/Faotage) : .--, ._�� . , .
<br /> ... .._...._. ...._ .. _ . - - : ,;,.._; .�
<br /> Drivew I ys-Not over Caunter if on pubila�roadways:neeiis ROW' -j _ _ -
<br /> �
<br /> i - -- - �
<br />
|