|
e��-�eo-ao�o City af Zephyrhills Permit Application Fax-813-780-0021
<br /> r ,
<br /> Building depattmen#
<br /> Qate Recetved P.hane:Contact for�Ferniittin
<br /> Y
<br /> Owrter's Alame � - e Owner Phane Number ����,� ��
<br /> Owner"s Address Z �� �'c f tc . ��I� •Owner Phone Number �� �
<br /> Fee Simple Tltle6older Name � �� Owner Phane Number �� ��
<br /> ,t .
<br /> Fee Stmple Tltleholder Addresa
<br /> JOB ADDRESS Z I�1 J�� � f� '2 - (t LOT# C��
<br /> SUBDIVtSiON �� � PARCEL ID#
<br /> (OBTAINED FR4M PROPERTY TAX NOTICE)
<br /> WORK PROPOSED .NEW CBNSTR ADDlALT �,] SIGN' Q Q DEMOI.ISH
<br /> e. INSTALL 8 REPi41R
<br /> PROPQSEDrUSE •- - � SFI2 Q COMM [� OTHER
<br /> TYPE OF CQNSTRUGTION Q` � BLOCK ' [� FRAME [� STEEI. Q �
<br /> DESCRIPTION OF WORK-' - ����- S{��,, '
<br /> BUtIDING SIZE �� �"SQ FOOTAGE . ,HEIGHfi ,��
<br /> �B��Ld»�' � ��� �,,.� VALUATION�4F TOTAL CONSTRUCTION
<br /> ��1
<br /> C�E�-��T����- , $� - � AMP SER1/ICE Q PRtyGRESB ENERGY Q W:R.E.C.
<br /> ��
<br /> OPLUMBlNG $ 1 '
<br /> � ,.,. �
<br /> QMECNANICAL $ VALUATIQN QF MECNANICAC tNSTAl1ATtON'
<br /> � �'.
<br /> QC,AS Q 1200FlNG Q SPEGIAR.TY � O'fHER
<br /> FINISHED FLOOR ELEVATIONS ��� FLOOD�QNE AREA QYES. .NO
<br /> � �
<br /> BUILDER �,,,./ COMPAI�tYY�• 'R�rizt_ OC�dt � '.,
<br /> SIGNATURE REGISTERED Y/ N 'FEE CURRE� Y/N
<br /> �ddrass . „ � . ' , .�L'icense#'� y�
<br /> ELECTRICIAN: - . � �.COMPANY ' ' ` r � -� ' .
<br /> SIGN�ITURE � REGISTERED Y/ N FEE CIJRRE�-' Y/-N .
<br /> Addrass ` _ .: Licen e. ��, �
<br /> ,_ .. .. S #�';I_ :• ;�,• �
<br /> Pi.UMBER ' COMPANY ., �. ... . '
<br /> SIGNATURE " . .Re���T�EREo Y../�,N:�. ;,FEE•,CURRE�_' , Y:/N, - �
<br /> 1�ldttr@�S l.iCeT1Se#�� - . . � - �.
<br /> MECHAMlGAI:' , . � ' COMPI.INY � ` , ' - _
<br /> SIGNATURE � � ' REGISTERED _ . , Y,/ N . � FEECURRE�. -. Y./:N- �
<br /> , �, • ,
<br /> Address � ` -- • - ` � ' License#'�- � I
<br /> . ,
<br /> O7FlER °' . � , _ _ � •':GOl4F/PANY -
<br /> .. .
<br /> SIGNATURE �-" _ �.� ".: .' ^� "- " °� ' ' � `REGISTEFtED` ` Y/ N... ' ' .FEE cuwtEn Y/N
<br /> . . :. . . „ . .. ,
<br /> Addres�, , . - " . ` ; � Cicense# � � � ,
<br /> . ., _ ., �. , :. ,,.=; ;: ,: ;�:.,...,�... . r t� = �
<br /> RESIDENTIAI::.;.= Attacti'(2).PfotrPlaiis;::{2}set"s:cf�Biiltding�F'lai�s;{1)"sefof�Energy�Forins;,Ft-0�W=Perrtiltfornewconstructton,
<br /> ;a Minimum:ten;(�1,0)-worlcing�days after'submittai'date;�Requli�ed onslte;�:ConsUiictlon�Rlans;`Stormwater Plans w/SUt'Fence installed,
<br /> ^� �Sanitary Facilities;&-:1;;dumpster�3ite:WorlcPermit#or_sutidiVislon§/large;prcijects,:,,-:.;, :.� ' ' '"
<br /> CQlHMERC(AL At#ach{3}�coinplete sets"of 8u11iling`Plans plas a l.ife Safelfyi Page;{1}set of Energy Farms.R-O W Pesmit for new cansttuctlon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConsUuctlon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary FaclliUes&1 dumpster.Slte Work Permit for ail new:projects:.All commerolal requlrements:must meet compNance
<br /> SIGN AERMI7 Attactt{2)sets ofEngliseer,ed;P.,'lans.�:: .;'�, �, �.� �� . .
<br /> "`"PROPERTY SURVEY reguired for all NEW construcd'on. .
<br /> Dlrectlon�s: � ._ . .
<br /> Ffli out applicadon completely.
<br /> Ownar 8 Contractor sign back of appifcalion,notatized
<br /> If ovar y2500,a No#ce af Corrtmencement 1�required. (A/C apgrades aver�,7800) ,
<br /> '" Agent(for the contractor)'or'Power of'Atta'mey'(fcir tlie owner)would be someone with notarized letter from owner authoHzing same
<br /> OVERTFiECOl3NTER.PERMi'i'CiNG ._:,.(Frontof-ApplicattamOnty}�- ' _ .. -
<br /> Reroofs if shingles Sewers Service Upgrades A/C , Fences(Plot/Survey/Footage)
<br /> Drtveways-Nat over Counfec,if_on.public,roadwaqs..needs 120W , � . t , � �., -': .,:,;�:- ;:;, _� :i -- .
<br /> ; ,;J3}=:ti=:_��;, ?=, '?'��: i .•'N�' `� i.•'. . �.',',:u=t�.::;� ^�J �
<br /> ' '�'" p'r���;;.{'r.'c?'irt.,�.'>;ir:�i��'`_ .�:. . `, f-M1 . .r � - - .`.—,,;,,,,a�-'J
<br /> s. �1�� _ �l". p u .��.���t4;f:.��!f��_52- -, ..
<br /> Nj fiy�l'�4����..����:....•. �.:3����.ti-- _ _ � �
<br /> +I Y *` ,+�+.�:�i.Y .n. .a... � , 4.�.� • .. . -�. • i
<br /> ,
<br /> .���iC:C�'� :,.n'`,_�I�. � .i i�. , ' ., ` ..� .
<br /> y _ ,
<br /> .. . . ...-.Ta_, ..�'a....r . _. .. .-. -. ._*= �
<br />
|