|
813aso-ao2o City af Zephyrhills Permit Application Fax-813-7so-oa2�
<br /> Building Depattment �r
<br /> '. . . ...
<br /> Date Received � � Phone�Canfacftor Pertntttin " _
<br /> Owner's Name � �1i �? ' . Owner Phane Number C���` ac �• ���..'�a
<br /> Owner's Address ' ''�',.�� - Owner Phone Number � ��J' • a 3 0-3"���—I
<br /> Fee Simple Tltleholder Name tj . Owrner Phane Nuinber �� • ��l�• �����
<br /> Fee Stmple Titleholder Address �!1�'�C -�✓ � �1�-�✓ h'ti - Y► �(_.. "��'�j��
<br /> JOB AbDRESS � 0�`-1� l �/l � �� . �I_. �'��J LOT# C�
<br /> - c ' ,
<br /> SUBdIVISION � S PARCEI,ID# i •� � '�� �" d Q D' �` �
<br /> _ , (OBTAINED FR4M PROPER'TYTAX NOTICE)
<br /> WORK PROPOSED NBW CONSTR ADD/ALT �,,� S1GN �Q Q DEMQGSH
<br /> �; INSTAI.L 8 R�PAIR �
<br /> PROPOSED=l1.Sf t ' .� SFR Q `COMM' [� tJTHER
<br /> TYP�C!F CONSTRUC710N Q' ` BLOCK " [� FRAME ��" STEEI: '� � „- �
<br /> DE3CRIPTION OF WORK ��
<br /> BUILDING SIZE � �'SQ'FOOTAGE�. . HEIGHT�.��
<br /> �BU������'' � 'd.�,�F�� � VALlJATION x]F�TOTAL CONSTRUCTION - '
<br /> . —�— .J
<br /> [�EL'ECTRiGAL �$ " � AMP SfRViGE Q =PRt)GRESS"ENERGY Q W.R.E.C.
<br /> ��
<br /> OPLUMBING $ � -
<br /> ��` /y�� /J
<br /> QMECMAN1CAt $ .f �. VALUATtQNOF-MECHANICA�INSTAL�ATIQN ��'j`� ��
<br /> �, " � U t
<br /> QGAS �. ROaFII�lG ,Q SPECIA1.n Q aTH�Ft
<br /> FINISHED FLOOR ELEVAT'IONS ��_____� FLOOD�ONE AREA [�]Y�S NO
<br /> BUiLDER CC�MFANY'..� - � - . .
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y�/N-
<br /> Address ' ,:..- �>�+ .= f� *•Ltcen§e# � �
<br /> , , _ .t � . - ,. . .., , '.... . .
<br /> �LECTRtCiAN; : - ,.;CCtiMPANY�`` , ,',� ,�� , ; � , �
<br /> SIGNATURE '� REGISTERED Y/ N FEE`eGwze�=� ' =Y/N"
<br /> l�ddre'ss � , . � �, � .,: License-.#s��' :��; �: } �
<br /> P�UMBER�' ' � CdMPAi�lY ; { t,.� . <
<br /> SIGNATURE` ` ; .REaIS7EREo . Y./..N�. -_.;.-�FEE:CURRE�; �: s:, Y/N..:-. ? y
<br /> Address �,License.#,,�. � � � ,
<br /> MECHANiCAI:� ` rt , . CQMPANY ' . ,
<br /> SIGNATUR� - ' � ` � i REGISTERED Y./ N 1 FEE CURRED,, � Y/�N
<br /> Address � ' ' ,- . � _ .License#�[ - .� � ,
<br /> OTHER ', " �,•-r'''~ � . �- ;GOMPANX' . � . . . �
<br /> �-�
<br /> SIGNATURE . .� " ��� � �r REGISTERED' Y/ N�� :FEE CURRE�' 1(/N
<br /> ,
<br /> , �.. .,
<br /> . _„ ; ..,..,. ;,. ;
<br /> t : : . . , . �
<br /> ..
<br /> t� l l- , -t ,;.. .. `�`�
<br /> Address '�"�t� �� <. : 1" - e, . i` Y�'lid`'a �`:���� License#`� I
<br /> � � .. �� ,-. re._. - .. . �._. . - ,
<br /> RESID�NT{At»;� �Attacfi°(2),Ptot Plaris;!(2j sets=of�Biiil�ltig�Ptan"s;('I}saf of<'Eriergy�Fa`rins;Ft-0=17Hs Ferzrilf for new canstttia�on,
<br /> : .... .; _.,,.,
<br /> �• • t. �Minimum:ten°(_:1,0);working;days;after:submNtal date::.Requtred 6nsite;�.GonstiucBon=Plans;'Starrnwater Plans•w/SIIt Fence installed,
<br /> ,. .��.:,�_:�.�,.,._ ...�.. ;_� ..._<,.. .
<br /> Sanfta"ryFadtitlesj8�;.1,dumpster�Site.Worlc.PermihforsuddivlsEonsQarge°:prflJects'_„.�-,: ` � '� � - -- - - -
<br /> COMMERCIAL Attach(3)'comptete sets ofBuildieg Pians ptus a Life�Safeiy Page;{1}sef af Energy Forms.R O W Fetmlt fo�neuv constructlan,�
<br /> - -�.,.- .--- - Minimum"ten(10)working days after submittal date. Required onsite,ConsUucNon Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Senikary Factlitfes 81 dumpster.Sfte Work Pernyit for.ai!new�projects.AU commerclal.requlrements_must meet compliance �
<br /> StGN PERMtT AttacFi(2j§ets of'Engineer,ed;l?lans::; - .. •. � , 0. •
<br /> ""«•pROPERTY SURVEY required.for aII.NEW,r:pnsWction.. _ - .,
<br /> Dlrections: ° °~�,` ~ ; � .
<br /> Fill out applicatlan completely.
<br /> Ownar&Contractot stgn back of appStcatlon.notarized
<br /> If over 52500,a Plotice of Commencement ls requlred. (AlC upgrades over 57500)
<br /> :-�.�;:-:s.�
<br /> " Agent{for the cantractor)or Pouirer of Atkbmey{for ttie owner)would be�someaine with notarixed letter from owner authorizing same
<br /> DVER THE COUNTER PERMITTING -.�(Front of-AppiicatiomOnly) - • - - `
<br /> Rerdafs if shingles Sewers*� Service Upgrades A/C Fences(PIoUSurveylFpotage) r ,
<br /> (Driveways-Not over Counter iP on public roadways..needs ROW �
<br /> d�.....>-:
<br /> }1
<br /> `.i
<br />
|