|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �- Building Department
<br /> Date Received Phone Contact for Permittin �/�J - �
<br /> 9 -:
<br /> Owner's Name �S� ^v � Owrner Phone Number U�c,J�' �'
<br /> Owner's Address V � � � Owner Phone Number
<br /> Fee Simple Titleholder Name - Ov�Iner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �� � ��� ~ `7 LOT# �
<br /> SUBDIVISION PARCEL ID# '- �D�- °-�O�O
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B ,. NEW CONSTR� ADD7ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP..OSED:USE Q SFR Q COMM � OTHER , ' �
<br /> TYPE':OF CONSTFtUCTIOM Q BLOCK •• Q FRAME �] STEEL ��
<br /> .. �, �! �
<br /> DESCRIPTION OF WORK / /X� �`J(, / � �t�
<br /> I BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> OBUILDING $ , Q VALUATION'OF TOTAL CONSTRUCTION
<br /> .c,
<br /> QEL:ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> _, .
<br /> QPLUMBING $ �j ����
<br /> G
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> Q,GQS Q ROOFING Q SPECIALTY 0 OTHER
<br />, FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> 9
<br /> BUILDER �` � COMPAPIY , 1�
<br /> SIGNATURE /� -. REGISTERED Y/ N FEE CURRE� Y%N
<br /> Address License#
<br /> , _ ,
<br /> ELECTRI,GIAN COM PANY
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N.
<br /> Address . . License#' ' - 'u
<br /> PLUMBER:;.:,, _ COMPANY- ,: - •
<br /> •SIGNA7'URE :Re��sTeReo �Y./-N-" ' FEECURRE� Y/N
<br /> _ Address, � •� L(cense#� �
<br /> :; ,.�:>< .:
<br /> ;;";MECHANICAL � _ :.COMPANY; . ._
<br /> '' 'SIGNATURE�"`' � � ` � ' ' REGISTERED - ,' Y/ N ' FEE CURRE� Y/N - .
<br /> Aild�ess�'• ` -� � � " " L-icense.# �_� �
<br /> :.r:;se4, • • . : - _ - . � .,. �
<br /> �,OTHER'�.,.;;._� ,, . . � , � - 'C:OMPANY . , �
<br /> �`�SIGNATURE,�;� ••* � • ' '� REGISTERED Y/.N-. � FEE CURREK Y_/N _ ; ,
<br /> : ;Address�., , _ .,�,.. ' , ... ,:�; . .. : - - ', License# � , . .
<br /> �.:RESIDENTIAL� ,� .i4ttacFi:,(2)Plot�;Plans;;(2);"seCs�of�Building�Flans'(1)°•setof'�Energy;Forriis;�R=O;VUP.ermit;f,ocnew.construction,� . - --
<br /> ,� _ �•r�f�;;.x.x,;,,.-;Minimum,:ten;(1Q).working�;days'aftec,sutirriittal�date.�,Required onsite;`Constru'ction Plan's;�Sformvirater Rlans,w/��Silt Fence�iristalled,-
<br /> ._, � - � ' ` Sanitary.;Facihhes.8;;1��dumpster Site:Worlc.Rermit.for.subdi'vis'ions/large'.p�oject§-...� � ' ` - = •- -
<br /> :,.COMMERGfAL' Attach�(2).qorripleCe�sets:of:Builtling�Plans=plus a'Life,Safety Page;;(.1)set of Energy-Forms.R-O-W Rermit.for new construction. " ` '
<br /> � � . Minlmum ten..(10);working days afte�,submittal'date.. Required onsite,.Constniction Plans;:Stormwate�Flans w/�Silt Fence installed,._
<br /> ` ' - Sanitary Facilitles 8 1`dumpster,�Site VUork;Fermit:fo�all new projects.All:commerciaLrequi�ements,must meet:compliance -
<br /> •� � SIGN;PERMIT -Attach'(2)sets of,Engineered Plans:�'t. .• 3. � ' ' - ' � �
<br /> ' , ` "'"*PROPERTY SURVEY�equired for,all,.NEW.construction:.: � . • -_- � - • '
<br /> 't,�^Directions: . ._ , �.--.:�ii .. .. - ' ' . � r, - _ _- . , ... .
<br /> �-� ; Fill�'out applicatlon completely. .. , :�� � - -
<br /> Owner.&�Contractor sign.back'of.app.lication,notarized _� : . . . , : .
<br /> I . If-over$2500,a,Notice;.of Commencement isrequir'ed. (AIC`upgradesover$7500),- �,_ , , ,
<br /> `-,� ,.�;; ,
<br /> , . Agent(fo��th'e�contractor)�orFower`of.'Attomey.(for;tFthe owner)would tie;someone witFi�notarized:lette�from�owner authoriiing:same
<br /> �,'�.OVER".,THE.COUNTER;PERMI,T;TING.. ._. (copyo_f-oontraatirequired)•�",`� � �:;`',� �, ' , ' - . �� �
<br /> �,Re�oofsifshingles Sewers ,Service_Upgrades..A/C= �Fences:(PIot/Survey/Footage)� � ' �
<br /> ' � �Driveways-Not�ove�Counter.if on�public rdafJwa s'z:^r�e2"dsRO, ' ,:�.�.»<.._..,�.�,„�..>,,,.�..�..��y:._..,...;_,.. ,"
<br /> Y. �G^'6;
<br /> i .., � ` - ` ' , � ,. � . „ _.i..�:F:'lif:i .;i�{r��.l:�i�1lc!���.ai�� �'�C!: '� , __ , •! '::It::. .. � .:�(' , . .
<br /> - �� � , ` , . .,. �.i�.�„ilio.,.�t10� ,l�.ii ?� ; .(.'.._.,ir_.c: ,..,c., , -
<br /> I �` - ' , _ " . .�`�t�_ .� ���,'s,!?•rJi:l'-i�l{:::.<' •.;"'�::: '� i 6:�.C'`�, :'t�i11'",',':�ii,;.:�I��:" " , .
<br /> - , �:�.:::�.��` .1 d, ,, � �".,
<br /> " � . _ � :i..y_�i±`.f;l;-.n,-C:1�;: ��., ';S�'.;'A(''`;�.^.. �:;:� •f , • ,.ifti"o".l;'v' .:�L:b:��i�;G�.6tif:.�?'1M,y`::: �},r;,r.
<br />� ' ��� -_-•.��a nr.a�c.-:�.t,ax�w.o�a,...ssa..is�-,e:}sw. -w�. ,;:e., . , . .-•-' --- - ---- -
<br />
|