|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �• Building Department
<br /> Date Received 2
<br /> �"—� -�, �Phone Contact for Permitting � ���J � - 3�
<br /> Owner's Name �T, �as� ��.,��0� �e, �N U��� Owner Phone Number
<br /> Owner's Address J 3l�o � I�S�fQ.�..� Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS S��L` LOT# �
<br /> SUBDIVISIOIV PARCEL ID#
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED ,. NEW CONSTR ADD%ALT Q SIGN Q Q DEMOLISH
<br /> B INSTALL e REPAIR
<br /> PROP.,OSED USE Q SFR Q COMM 0 OTHER .
<br /> TYPE'OF CON$TRUCTION Q BLOCK •• Q FRA(UIE 0 STEEL Q
<br /> DESCRIPTION OF WORK "-�' �Z` ��-�y 1 � ��� � � �.C
<br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT �
<br /> QBUILDING $ ��8��,�� VALUATION'OF TOTAL CONSTRUCTION
<br /> QEbECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION . �li'�
<br /> � f
<br /> Q,GAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> I BUILDER `,�„ < ,� y � " I ,) COMPAtdY I
<br /> SIGNATURE '��'t�—'�� Z� � REGISTERED Y'/ N FEE CURRE� � Y/N
<br /> Address License#
<br /> ELECTRI,CIAN COnfI PANY
<br /> - SIGNi4TURE REGISTERED Y/ N FEE'CURRE� Y/N
<br /> Address ' License#. 'J
<br /> ' F�:;'.,'�.- , , ,
<br /> � P.LUMBER.,_: , COMPANY �ti ' � ' � �
<br /> •SIGNqTURE � -REGISTERED :' Yr/ N. FEE CURRE� � Y/N
<br /> Address � License# ��
<br /> .;,. .�,. . -_ �
<br /> „ .MECHi4NICA1; - ' ' , COMP.ANY �
<br /> ' SIGNATURE`' ' � - REGISTERED , Y/ N FEE CURRE� ' Y/N-. �� " � - . -
<br /> �� l,a,.;. '
<br /> Aiid�ess-� - ' � � � ' License.#-
<br /> .�,'
<br /> "',ii;.,:: � ._. .. � , .. . , -
<br /> .-',OTHER's•,.r,•:. . _ ,� , . COMPANY
<br /> `-_SIGNA7`URE;;>; .�k; _ - • "' � 'REGI§TERED- Y./N. FEE CURREK . Y/N
<br /> . - s.- .. , „ :.,
<br />' , .. 'Address�-<,. ;:- _ :�.:;,.: . �;:� � .. � � License# - . _ +. .
<br /> `=RESIDENTIAL^�:.•Attach."2�'.Plof Plans'�2::sefs�of`Buil'din��'Flans•°.1•��set`of:Ene'�� �For'ms�R=O= .:Fe� �i�-f���rnew.� � � - . �
<br /> , _... . . __., ;,� ),,.; , ��(.)., . , 9 ,�..). ..: ,,.�9Y;_F,.. ,,.�_,,._;,W.. rm t,o. ._ constiyction;,'- ,
<br /> ,. � ;;;,�,� _- .;�Minimum'.ten.,(�10)'working;days;�after;sutimittal:rdate:_:Repuired'on§ite;ConstniCtion'Plans;Stormwater Plans;uv/SIIt Fence'in'sfalled,� ,
<br /> � �' �� ���`� 3anitary,•;Facilities8��1du'mpsterSife,W.ork.Permitforsubdivisionsflarge�p�ojects` ' �� ' - � � =
<br /> �:�:.;GOMMERGIAL' Attach:{2)complete'sets:of:Building Plans plus a�Life Safety Page;:(1)set of.Energy Forms.�R-0-W Rermit foc new construcBon.',"
<br /> , . ,,. - � Minimum ten,(10);working days_after,subrtiittal.date. Required onsite,.Constiuction:Plans;;Stortnwater Plans w/,•3ilt Fence�installed;, , . � .
<br /> `.. �� " �°`':� Sanitary�Factlttles&.1:dumpster._Site Work,P.erriiit:fo��all-new projects.All:commercial requirements;must meet"compliance �
<br /> `,>- _. . .... ..,...- _ . - .
<br /> '..-SIGN-PERMIT� - Attacti'.(2)sets of;Engin"ee�ed Plans:��`�. . � -- , - � , - " ,, �
<br /> ,• • .:,: :,• - ..,.P - -
<br /> ,',-,, ;� .f;+ ._,_ , .:RORERTY SURVEY�equl�ed,for::aII:NEW construction:�•�- �� .- , . , „
<br /> ,.� _ �. - ,
<br /> ' .Direction's:- ' :.�, -•� : ;` -�'.,i;::. .:. _ , � , _ . : , • ..- . _ .
<br /> '. -�Fill:out application completely;- - � `
<br /> -- O.wner B,,Contraotor sign:back;of;application,,notarized _ -,., - .. , -_ �
<br /> ',�,�� ,� If'o'ver$250Q a�Noti'c.e.of:Commencement`is cequired:„�(A/C,upgrades"over$7500) . . _ �
<br /> ..,- ,. _ , ,
<br /> `"-.' Agent�(for'tti'e,conVactor)�or Fower:`of'Atto"mey:(for:tFie owner);would tie someone;witFi:notarizedletter,from owner.authorizing:same
<br />� ',�;.OV".ER�.THE';COUNTER�,P„ERMITTING.,J-:"`.,'.."(copy.,o'f,contract-required);=a' ;�""�:'� ': � ` ' - � '
<br /> ,;'�=Re�oofs ifsfiingle's� .'°`Sewers` ; �,.Service.Upgrades�A%C': ,Fences(PlodSurvey/Footage)�� -' '
<br /> �--���Drlveways-Not over.Countee if.on:pu6lic roacJways.;needs'ROW.,. ' �� � - , �
<br /> ,. � , ., ,- - , . , . , .i
<br /> . - �� � —. _, - . - _ ,. . _�� � c.r.,�m� ..c,-
<br />
|