|
� L�13-�ao-oo�o City af Zephyrhills Permit Application Fax-s�aaso-oo2�
<br /> r ,
<br /> Build�ng Depattment
<br /> Dats Recelved p1��sne-GonNact=for�F�rn�tttin !� ��� _o�L�
<br /> Qwner's Name �GL/� f' �,Q✓� Owner�hone Nunnb�r �!���tT cg-wcac
<br /> Owner's Address �a �/�v "� 6-�,�z� Y� Owner Phone Number �� �
<br /> Fee Simple Yltleholder Name � +� � Owner Phone Number �� �1
<br /> ,$ - �
<br /> Fee Slmple,Tltleholder Address �
<br /> JOB AD�RE3S� �� d G/� LOT# ��
<br /> SUBDNiSION • �/'�1�.��+GGN � P.ARCEL-ID# '�� e�� ta�� � G/��� �'�.'��i'd ���4�
<br /> , (OBTAINED FROM PR�PERYY,TA7(NOTICE)
<br /> WORK PROPOSED �NEW CONSTR ADD/ALT C� SIGN Q Q pEMOL.iSH
<br /> ;e. INSTALL. REPAIR ~ -
<br /> PEtOPOS6DrR1SE Q S�R Q CQMM Q OTHER
<br /> TYPE OF COId3TRUCTION �- 'Q ` 'BLOGK " Q FRAME [� STEEL` Q
<br /> DESCRIPTION OF WORK ' �B'r�` i �6�` C.I'�F�N e��D7.G� �r � �/� � �pr7'y') O Lo/V1�
<br /> BUILDING�SIZ� "r� � SQ�FOOTAGE � , HEIGHT iC��
<br />� QBUC�DING � � VALUATION:'�L1F TOTAL CONSTRUC710N N "
<br />� QECECiRICAt, $ ' AMP SERVICE Q -PROGFtESS ENERGY Q W.R.E.C.
<br />�
<br />' QPLUMBING $
<br /> ��:
<br /> QMECHANICAL $ VALUATION OF(tit]ECHANICAI.tNSTAI_IATt{,7N
<br /> � 3��::�. ��..
<br /> �c�s o �oaF�N� :o sPEciA�Tr � OTHER
<br /> FINISHED FLdOR ELEVATIONS � �-� FI.00D ZONE AREA �YES. NO
<br /> BUl�DER COM#i�4VY', , � .
<br /> SIGNATUI3E REGIS7ERED Y/ N FEE CURREA Y/N' .
<br /> Address � - '��°' � L3cense#`� �
<br /> _ �:: � , . . .. . .
<br /> El.EC7RIClAN, , ' ' r.C�MPANY''' "� ` � .� � � " .
<br /> SIGNH►TURE � REGISTERED Y/ N FEE GURRE�-' •�`•'�Y/�N "
<br /> Addre4s - • . . •� � }, �License•.# }� - , � . , ' _� �
<br /> PLUM�ER COMP..Afi�Y , + f ' t � - -
<br /> .. ., . ..: „
<br /> , „
<br /> SIGNATURE� '` , , REGISTERED Y.G�N;i �•; .:FEE�CURREA• =. Y./N; ��;. •-
<br /> Address ' ` � � _License.# �� . . r�.,.
<br /> ; � � _ . •4� � �., .
<br /> MECF9ANlCAl:` �,� . COMPANY J�R-� . Q-N"��-����"'��� �11�U ,
<br /> $IGNATURE � ` REGISTERED Y.,/.N . FEE CURRE�_. Y.I-N; :
<br /> Addrsss: ' - 7��1 � <-�J�: , , ^. .License# �������,. �
<br /> OTHER � . �' �GOMP�lF1Y , - -
<br /> SIGNATURE .. - � ' • •� ' ' REG�S7EREo Y/ N,... �.FEE CURREn Y/N
<br /> Addrss� ` -- , _ _. ticon`se# � � � _
<br /> ,.,._._,.,,._.•>,<. ,_. �.,.•,.r_.r. ,� .
<br /> RESIDENTIAC:4:_ llftacti"{2};Plat�Platisr{2}si�ts:of.Building�Ptan's;{1}'sef af�Energp^�orins;��R=0=11V;P'eiisrit tti�new cbasUui:tion, ,
<br /> �, .. �, ;..., �.....• �.: . _,.
<br /> ;;..Minimum;ten�.(:1,0),working�ciays_'afte�:subinittal date.:;Requlred onsite;.Construc8on Plans;�Stotmwate'r Plans w/Stlt Fence installed,
<br /> �,�,�.�.„ :..:.-. �,. . :_ .,
<br /> SanitaryFacllitiesc&�1;dumpster-�Slte-Woric,:P,.,ermik#or:sutiilivislons!large:proJects�'; �F „- � - � • �
<br /> CdNlMERCIAI. Attach{3)�tzomptete sets of Building Plans pt'us a`Cife Safefy�Page;(1}set of Energy Forms.R A-W Permit for new construction, - -
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construcdon Plans,Stormwater Pla�s w/Silt Fence installed,
<br /> Sanitary Facilitl�s&t dumpster.Site Work Peranit tar alf new:praJecEs:.AU commeraial requlrements.must meet camplla�ce �
<br /> SlG1V PERMiT Attacii(2�"sets df Erigliteered=Plans:;;� T°,; ~�,: �.-. � •
<br /> ••`"PROPERIY SURVEY required_for all,NEW:gonstructlon.,, r. �,
<br /> Directions: , , � _ . �.
<br /> Fill out applicadon completely. ,
<br /> Owner&Contractor s[gn back at appticatEon,ROt"dfiZSd
<br /> If over 32500,a Nottce af Commenceenent i�requi�ed. (A!C upgr�des over;7500) , ,
<br /> �.... t.+,,,��,�zi„�'% �a:�+�i�fi
<br /> rrr wxu^»ll�ae`-' $�,�*rt�;;.,.�=+
<br /> Agent(for the�contractor)or Power of'Attomey�(far tt►e o�wc�er�wo�ul�d be someone with notarized letter "m owra�r�u 1 oµz�ng,sam� �t���r,,,
<br /> N Aa 1�..+"':.�' ,, ( ' �.4-'at5`��a r �4
<br /> .Y.Y.J.:�f r'9. P`aR't
<br /> OVfR7HECOUNTERPERM1�TiNG'� �p���r�ytpf,,APBiication^ r�i�t�.,�t F.�I;c�'�,;+,,t::i�.:� . .t�c„n;i �':,`��.::: �.
<br /> �i fa s f3 r;y, , r,��it �: *��� ,i
<br /> Reroofs(f shingles Sewe�.��:���erv��ce,Upsq�,d�ss�`,/�� a� 4j�h�'� t/Survey/Footage) fi PG;:, t f:,�,<fl �. ��;y R r._-
<br /> y yt. �st ai 7Rt�Cli��' '?leT.t�.���.�. a ��`S� s���t ��.�`it°-{fi tit ` ;t:fl?f::i ~:p� Y�,;` t:l.
<br /> Driveways-Not over Cour��e��F'on��iubl�c r,�ac�v�a�y��E=needs`i2.��:�,;��� �t�a�2 ��?;.-,�,.�,r_ ;.,, • '-,;;,,,.__ ,
<br /> <<�� , :,,, ;,�;, s:,:��..x r,::::,:_;
<br /> i�t.� t: r � ty�c�"9:r���r�� n;� : axa��r,,rv.,�.;::�
<br /> tn� ue?�'u�JGfi i� ''�"� ,_J„"�'a. . ._ . _y'- 5*`C.
<br /> ��.;t-'.;�.1iF`1G�r.i:,�}{)t:cX� 1� n�,�uy;�y'�qe�•.,ey
<br /> ..��.--q+i"-;�=%-.,KmBvt�'#�e�.ts.°c""'�`�wc`�::1" - ��
<br /> f�"f �'
<br /> ��!
<br /> '��
<br />
|