|
813I-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> i • Building Department
<br /> Date Rec�siveld Phone Contact for Permitting • D�3 �d c� -- �b/�
<br /> Owner's fdarr�e `�JIIV��°/�S �D��L,� � �f�11� Owner Phone Number 5 f �L/
<br /> � �2�%�-iv� �e/�
<br /> Owner's Addlless �����— �/� . �, Owner Phone Number
<br /> Fee Simple T(tleholder Name Owner Phone Number
<br /> �
<br /> � �
<br /> Fee Simple Titleholder Address
<br /> I �JOBADDRESS �0 D� C��IZJSr//V� �L�� LOT#
<br /> susoivisio�I, ��j,+��'S /I�i� PARCEL ID# �� a/ DdaD �Dap� �' �i
<br /> i (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e , NEW CONSTR� ADD/ALT 0 SIGN 0 Q DEMOLISH
<br /> IINSTALL REPAIR
<br /> PROPOSED UISE Q SFR Q COMM � OTHER
<br /> TYPE OF CO(JSTRUCTION 0 BLOCK - Q FRAME � STEEL Q
<br /> DESCRIPTIONI OF WORK /►�S� �/G° C'�fr�-N e--o tc i / �D�'n /i�2/1�� � � �d,��k ��
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT
<br /> �BUILIDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLU BING $
<br /> � ,
<br /> �MECHANICAL $ ��a 5� b VALUATION OF MECHANICAL INSTALLATION
<br /> I OGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �
<br /> �
<br /> BUILDER COMPANY
<br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAN COM PANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N '
<br /> Address License# �
<br /> PLUMBER, COMPANY
<br /> SIGNATURE , REGISTERED Y-/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL ,A�`����� COMPAtdY h�1�f�it��S /� r/rv� ���C ��NCJ
<br /> I SIGNATURE �"'""-'� ��� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �/ S�/ ���P�/ I� / GS /�� �icense# A�D �f 3�f 9�
<br /> OTHER ' COMPAfVY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y./N
<br /> Address License#
<br /> RESIDENTIAL Attach(2)Plot'Plans;(2)_sets�of•Building Plans;(1)set of Energy Forms;R-O-W.Permit for new.construotion, �
<br /> - � Minimum.ten'(10)working.days after submittal date. Required onsite,Constniction Plans,Stormvuater Plans w/Sllt Fence installed, �
<br /> Sanitary Facilities.8 1 dumpster;Sife.Work Permit foc.subd'ivisionsAarge projects
<br /> -.COMMERCIAL I Attach•(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> . I Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, �
<br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.Ail commercial requirements must meet compliance '�
<br /> . SIGtd PERMIT Attach(2)sets of Engineered Plans. , _
<br /> ""PROPERTY SURVEY required for all NEW construction. �
<br /> , I
<br /> Dlrections: I '
<br /> Fill out appiication completely.
<br /> i i
<br /> Owner&Contractor sign back of application,notarized � �
<br /> If over$2500;a Notice of Commencement is requlred. (A/C upgrades over$7500) �
<br /> " Agent(for thelcontractor)or Power of Attorney(for the owner)would be someone�with notariz d.letter fro o.w a o' i�]Q sa , „
<br /> .•7-,•t:•.a4:u_•sS.r.4:(i.".zttY'1Ylh',�Je.+k�ni - �' 'S �1 �c :.G�1+����1-+e�M'il+.IG��
<br /> � OVER THE COUNTER PERMITTING�E,�:.•; ,(copy;of contract,requiyed)� ?,i�iit<�E�S,Ft�(lt3'�4 ,���;',!;;•,,, '
<br /> Reroofs if shingles� .SeV1(�fS,;�i;yq n!,�j�.2Nl 5 pg a e �(i�"''.•'4a� + ''i�;;�'ir; �`��"�t'�} �
<br /> ce,,y � fj 5 Y ,u�F�n es(PIoUSurvey/Footage: s+�?f�4, �G i�iQU�. 'Q'i��DG� `'��.ar ""e1:i.
<br /> I �7�.s.,-. :' !4;i..{�'�;,x:f iAlli;l.l�1r4 :,�f����iF ^ '',If!: i:.'� ?u:.�,3:if471� '�!S'0.' �ir: ' ����� `'i•'
<br /> Driveways-Not over'Countert i�f,on:p�blic,f,;o,�dy,�,ays..ne�ccj��la�ql^ d;:;c,��.+},. � r,:.r,v,�:im�v;n a =:<f���.��;`
<br /> , .. .. a,.:�8� �.,�ea•,a�,
<br /> � it�. a�i.:'C'.lLa61'>',F•,^,!?ie,B,�'�A�tt}: +��`%i+tiiiss'�'� i'ae�+�:i�;!i�f6.�1�+iSYa r1�!G���r;�P}�i[G ��»ue�"�
<br /> ..�-'��`"�o�K,fs''^�'�!'�°"y�"''�3."�i'- �i ��f�',
<br /> I I
<br /> -- I -- I
<br />
|