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813•780-0020 � �
<br /> City of Zepiiyrhills Permit Application Fax-813-780-0021 ,
<br /> Building department
<br /> ;._,;-� �` . ` , �
<br /> Date Recelved _ . � Phane;Cdntact fqr Permtttin � – '
<br /> Owner's Name ` � � � � Owner Phone Num6er I�f 3 g l � � ! U ,
<br /> Owner's Address (� ,i Owner Phone Number � �
<br /> Fee Slmple Tltleholder Name Owner Phone Number �� � �
<br /> Fee 5lmple Titleholder Addr�ass ',
<br /> �
<br /> dOB ADDRESS � ) t�G2. tt�1►° a. �? .%�f S � �.. � �or# �.� �
<br /> SUBDIVISION �� � PARCEL I� k�
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE) ,
<br /> WORK PRQPOSEO : NEW COtVSTR ADDIAIT C� S1G�4 Q• Q pEMO�.tSH '
<br /> INSTALL 8 REPAIR !
<br /> RRQPOSED.USE Q SFR � CQMM Q OTHEFt '
<br /> TYPE OF CONSTRUCTION Q BI,OCK " Q FRAME �� STEEL Q �
<br /> .; 4
<br /> DESCRIP'fiQN OF WORK � )� *� �, J � b j S C %C, n
<br /> . I,
<br /> BUILDING SIZE • �'' SQ FOOTAGE C_� HEIGHT� ,_� �i
<br />� _ �
<br />', ���s�����' $ VALUATtON�G}�F�T'O'fAl CONS'i'Rt)CTION . -�
<br /> „���
<br /> i QEL•ECTRICAi. M � � AMP"SERVICE � PROGRESS ENEFtGY [� W.R.E.C. �
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<br />' OPLUMBING ��� ' 1
<br /> OMECNAN{GAL $ � VALUATION OF;MECHANICAI.INSTA�LATlt?tV. �r�r, f� L � `�
<br /> �, ,,,_� � �
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<br /> C]GAS Q ROOFIl+tG Q, SPEGIALTY � OTHER ,
<br /> FINISHED FLOOR ELEVATI4NS �� F1.00D ZONE AREA QYES NO
<br /> BUILDER COMPANY`� � " � `
<br /> SIGNA7UI2H REGISTERED Y/ N ` �E cuR�n Y/N
<br /> Addresa • ,.;, Cic�nse# �� �
<br /> EtECTRtC1AN, - ."COMP1tNY -
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�° �Y/N
<br /> y.
<br /> Addre� � llcense# � � � r �
<br /> P�UMBER ` . COMPANY � . . ' - � , , i
<br /> SIGNATURE` � ' .REGISTERED Y/�N� ,,FEE CURREA Y-/N.
<br /> � i
<br /> Address + .License#� � 1
<br /> MECNANICAC� . , , COMPAtiY, . .
<br /> SIGNATURE ' ' REGI§TERED,, Y./ N . ;, FEE CURRE� Y/•'N
<br /> Addreas��� � ` - = � � ` � � � ` � Cicanse# �,� I 1
<br /> t}THER • :- . ` � ' ;GOM'PANY, •
<br /> SIGNA7URE' "�� " '� ''- �' ''' REGISTERED Y/ N�..- FEE CURRE� Y/N
<br /> Addres� �� _ -. ` � • L`icerise#"�— '� � �
<br /> ' ., �3;",i ;,� ii- } ..::.i.,e ..,' : � • � � ,� ' �,
<br /> RESID�N71Al:��; :Attach°{2},:t?totj.Ffans;_(2)ssfs°-of�Buftding�`Flait"s;(1)set of•Energy�Farins;RA�W'Pei�nit for new oaostruc�on, � .
<br /> •. �., �Minimum�ken�(1.0)iworking;days�;after:`subiniital''date.�:Requ�red onslte,�Constiuction-Plans;Stortnwa4er'Pians wJ Siit Fence instailed,
<br /> :.,
<br /> ..,W;_,� _.
<br /> 3anitary Faciiitl,es:&�;1.,dumpste_r,.�Slta�Work,;Permit#or subdivislons/large prn)ects:'_ ._"�..:- " � ` - - -
<br /> COMMERCIAI. Attach�3}•tiximpfete`sets`of Buildtng Ptaiis ptus a I.ife Safefy Page;(1)set of Energy Forms.R Q-W Petmit#or new cvnstructlon,
<br /> Mtnimum ten(10)working days after submittal date. Required onsite,Canstructian Plans,Stortnwater Plans wi 5ilt Fence installad,
<br /> Sanitary Fadlitles&1 dumpster.Site Work Pemrit for all new:projects.All commercial requlrements.must meet compllance � �
<br /> S1�H PERMI7 Attai�f"{2)sets ofEiiglrtieeied_Plaris;. .�;.., .. . �
<br /> ""'PROPERTY SURVEY required for all NEW constructlon. ,
<br /> Directian�:
<br /> Ffll out applicaUon completely.
<br /> 4wner&Gontractor.sfgn back of appl(caUon,notarizad
<br /> If ave��:500,a Notice of Cammenc�ment is requlred. {AtC upgrade�over ST54Q}
<br /> Yw -.:."j};i.,,` ''",
<br /> Agent(for the contractor)'or'Power of Attorr�ey�(far,tFiepwner)would_�.e�someone with�notarized letter from owner autho�izing same
<br /> }__<....<,�....._; . , ;
<br /> DVER THE COUNTER PERMiT'f1NG� �:_ -(Fmnt of�1�Pp11catibn,Orilyi).:' ' 'i
<br /> Reroofs lf shingles Sewers � �Seniice Upgraides A/C" ' ' Fences'�PIoUSurvey/Footage) . '�
<br /> ,� . � � .,, .�• . .. . -� ,
<br /> ._ _. _ ,. .. ... ... ... .... .. . . . .�'���• � _ _..�•.
<br /> Drivewaya-Nat over CaunterJf on pubflc roadways.:neails`ROW.,�g�
<br /> m , � ..,�,, , -r .. �
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