|
813-780-Q�o2o City afi Zephyrhills Permit Application ;� Fax-813-780-0021
<br /> Buitding Department /� , �
<br /> . •'j� �S�G'C�[�G,�i c�r'����/`��/'�� Co.�a-�
<br /> Date Received Phone Gontact for Permitting -- �,
<br /> ii
<br /> _I.��_..rrl...T—
<br /> Owner's Name �. �4 a c-• � Owner Phone Number ���'Z.�, �- �� t!
<br /> Owner's Address I ��64�+�'��e �-'" P'^` �'� ���"`/�c�^'� �/Owner Phorie Number �-!r �
<br /> i $�
<br /> Fee Simple Titleh�Ider Name � ��."-.rn� '� � Owner Phone Number �-i'; �
<br /> \ ;� . };
<br /> Fee Simple Titleholder Address ���'1- `k
<br /> JOB ADDRESS � �/^""Y`� -?- /��".-- C�'"7" LOT�# / �/�
<br /> SUBDIVISION ✓ I�l ��=r'�= �e�� PARCEL ID# ���-�'�'r�/ �� ��'� ������ ;���'�
<br /> {OBTAtNED FROM PROPERTY TAX NOTICE) '
<br /> WORK PROPCISED �NEW CONSTR 8 ADD/AL7 � SIGN � 0 I'DENIO�ISH
<br /> � INSTALL REPAIR
<br /> PROPOSED USE; �'"� S�R Q COMivI � dTNER
<br /> TYPE OF CONSTRUCTION � BLOCK � FRAME [� STEEL � '
<br /> DESCRIPTION��F WORK Y1 C� S�u �c�'�rn..1 �, �'�'S�c�a"=./+�� ��'e� b��-!^� -��cx-`�
<br /> �
<br /> BUILDING SIZE�� �_ � S4 FOOTAGE c���� HEIGHT �_� �! '
<br /> �r-r-r-�"'re'7�
<br /> �� �;
<br /> �BUILDi NG � � y� �� VALUATION OF TOTAL CONSTRUCTION �
<br /> i� J . �'
<br /> !
<br /> �ELEC�RICAL $ r���� AMP SERVICE O PROGRESS ENERGY sQ W.R.E.C.
<br /> ( '. �
<br /> �PLUMBING $ �,���
<br /> � �^f
<br /> ,OMECHANICAL $ VALUATION OF MECHAN(CAL(NSTALLATiaN {5
<br /> ; ��d� .
<br /> �GAS, �� RpOFING Q SPECiALTY � OTH�R ;,
<br /> FlN1SHED FL(70R E�EVATIQNS j� , ��� ��OOD ZONE AREA �YES NO �.,
<br /> � J
<br /> ••1-�f-4•�-F•I•I:�i-4-W-1--4-R-1--i�-1-1--1--1-��-1�-i•�1-1-1-1-1-1--f-f-1-{-1--1-i-1--i-1-H-f-1••1--{-E••1--8-• • • • • •''�• •' • • 4-1-1-T
<br /> � 1�� R` ;
<br /> BUILDER � ��� ,� COMPANY �•� - 4����"^ '�, I�'�
<br /> StGNATUFtE s�� ftEG16TERED Y/ N FEE CURRE� Y/.N :
<br /> Address ����cr��'C��CC�/� n�r"' �� �"' License# �C-�����" �
<br /> ELECTRICIAN �f� ..�' COMPANY �� 1'Y�O�sp� ��"�e-�r� �^
<br /> ' SIGNATURE � �s "'�� ftEGiSTERED Y( N FEE CURRE� Y I.�`1
<br /> Address �� � 5 K-i I��r' !'���G rr+ �- License# ������ a a g
<br /> PLUMBER � ���,,� COMPANY li d�/"? !�l'-^�Ta I'i `�-/ !'0'"''��
<br /> `'-
<br /> SI�tJATURE �� RECaiSTEREp Y/ N FEE GUAREn —�/_N
<br /> Address � �y�P �C�' G�(� e ��� '�'6L License# G�� ��2���--I
<br /> MECHANICAL. ���,,,...,�...�.�.., COMPANY ►` I�D�r�SJ i 1.�� �t�f'�LJ �`��'n r
<br /> SlGNATURE�) AEGISTERED Y/ N FEE CURRE� Y�:N
<br /> Address ��jG"� �s�e��'f. �G;ra-r�T c'..�"� License# �J�T'����� 1G?IQ� �
<br /> OTHER �'��,,,�,,.�,. CQMPANY �I 1 ��Cr�"'� ItO��� �s ,_-�
<br /> SIGNATURE, REGISTERED Y/ N FEE CUFRE� Y/N
<br /> Addres i ��� j ��1' s7�'" �G�++n "'�' License# C,C:.4 �� � � � �
<br /> 11i1I11 / [ 11 [ tl / ll [ / lill11111 [ li [ 1111t1II1 / 1 [ itititllll ,1111' ltili1111
<br /> RESIDENTI IL Attach(2) Plot Plans; (2)sets of Building Plans; (1)se#of Energy Forms; R-O-W Permit for new construction, .;
<br /> Minimum ten (10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt'Fence installed,
<br /> ; Sanitary FaciJities&1 dumpster;Site Work Permit far subdivisiansllarge projects {
<br /> COMMERCI IAL Attach (2)complete sets of Building Plans plus a Life Safety Page; (1)set of Energy Forms: R-O-W Permit far pew aonstruction. I
<br /> � Minimum ten{10)working days after submitta!date. Required onsite,Construction Plans,Stormwate,r Pians w/Silf Fence installed,
<br /> Sanitary Faci(ities&1 dumpster.Site Work Permit for a!l new projects.A!1 cammercial requtrements m�3st meet.compliance
<br /> SIGN PERMIT Attach (2)sets of Engineered Plans. , �� '� � ' '
<br /> � ****PROPERTY SURVEY required for aA NEW construction. "�'� �
<br />� ■ �+�..�s�i��� {�i�i�l--i�i�{.�i�{�{-i-{�i..{..L�1.��-.{�•�i-i-i�i..l�4.i..iot�.i�i�I--i..i�l..i-i�i..i-{..{..}.�j�1..I.-R+� ■ r ■ if'■ • � ■ l�i..I--1-i-+
<br /> pirections:� ; ',
<br /> Fiii out, pp(ication completely.
<br /> Owner�&Contractor sign back of app(ication,notarized . ,
<br /> If over�$2500,a Notice of Commencement is required. (A/C upgrades over$7500) .
<br /> ** Agent�far the cantractor}or Power of Attorney(for the owner)would be sameone with notarized Ietter fram owner authorizingEsame
<br /> :.��,.::.....
<br /> OVER THE COUNTER PERMITTING ``(copy of,contract regulred) - �- � , , - ° �
<br /> Reroafs�f s ingles Sewers Service Upgrades�AJCr'.:,:.Fences(PiatlSunreytFaotage) ' . -, , '� ,
<br /> ; .,,.-.,. ,. .��_': ,• . ,. ,
<br /> prive ays-Not over CouMer if an pubiic roadways.'.needs ROW� , , �;� � } � , . � •
<br /> rt ., .. ..-.�, , _ , ``' • � .. - .
<br /> r
<br /> ,
<br />
|