|
s�aaso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department
<br /> Date Receiv�d ��j "a,`�j 7 � phone Contact for Permittin ��� �� f — � �
<br /> g:..
<br /> Owner's Name -- I, � ; Owner P�ibfie 1�i)m'beF , � YJ� �J�� ��
<br /> Owner's Address � g l�. , a� 5 Q��] Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � O � Zj��� ��� LOT# �
<br /> SUBDIVISION PARCEL ID# ��26 � 10��0 r��Qa �� )�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROP.OSED ,. NEW CONSTR ADD7ALT Q SIGN Q Q DEMOLISH
<br /> B INSTALL � REPAIR
<br /> PROP,,OSED'USE SFR Q COMM [� OTHER
<br /> TYPE':OF CONSTRUCTION BLOCK - Q FRAME 0 STEEL Q
<br /> �+ J )
<br /> DESCRIPTION"OF WORK �� , 1 Q(J R S�'1)
<br /> BUILDING SIZE �� 5 SQ FOOTAGE�� HEIGHT •
<br /> �BUILDING $ �LS O VALUATION'OF TOTAL CONSTRIJCTION
<br /> _�
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> F.
<br /> QPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> OGAS ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIOfVS FLOOD ZONE AREA QYES NO
<br /> BUILDER // � COMPANY �11�' �Op7, r roo �
<br /> SIGNATURE G�l�� (/ REGISTERED Y�/ N , FEE CURRE� Y/N �
<br /> Address �j�� /�j%) /' p /C�(� License# CCC 33�o a
<br /> 'ELECTRICIAN COM PANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address - License# '
<br /> -,..
<br /> P,LUMBER,, COMPANY
<br /> 'SIGNATURE REGISTERED , Y:/'N � FEE CURRE� Y/N t
<br /> Address. � License#'
<br /> MECHANICAL ' � COMPANY - -
<br /> __SIGNATURE'�" � REGISTERED , Y/ N FEE CURRE� Y/N
<br /> Add'ress� - • � License.#
<br /> °;>i,,,_ ....
<br /> ; OTHER� "^ • COMPANY
<br /> �� SIGNATURE- � - - REGISTeRED Y/ N FEE CURRE�' Y/N
<br /> F.': , � .
<br /> � Address.: ' _ � � License#
<br /> ':.��•.R�, '. e , .
<br /> ���';R�SIDENTIAL�,�W'.Attapli;;(2):PIof�P.lans;'(2)::seCs�of�Building=Plans;;(1-)`set ofEnergy'For'ms;R;O-VU.Permit,for new.construction,
<br /> : iti t
<br /> ;h:�-,:;;�:�;:>...�,-�.Minimum:ten�(t10);working'days afte�;su6mittal�dafe. RequirecJ`onsite;"Gonstruction`Plans,'Stormwater Plans w/Silt Fence installed,
<br /> - ,:,_:...:�:._,..,,� . .�:�,_,......._
<br /> �� ' - - Sanita.ry._,FaciliGes;&�:,1..dumpster;;�Sife:;Wor,k Permit for,subdivisionsllarge��projects� � ` � '
<br /> �h:.COMMERCIAL Attach 2`com lete�sets'of Buildin-�Plans lus a L'ife Safe Pa e; 1 set of Ener Forms.R-O-W Permit for new construction.
<br /> � ) P 9 P tY 9 � ) 9Y
<br /> : Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> "•"` Sanitary EaciliUes 8�1 dumpster.,Site Work Permit fo��all new projects.All commercial requirements.must meet.compliance '
<br /> ��.�SIGN�PERMIT �Attaoh'(2jsets;,o,f,Engineered.;P.lans:� .• ., •
<br /> �`' ""`"PRORERTY SURVEY[equfred fo[:aII,NEW construction..-
<br /> h'� _
<br /> =i. ' '" ' ' '
<br /> ��Directtons: . -s�,•,� .,.- .
<br /> - "' �Fill,out application completely.
<br /> =0wner.&Contraotor sign 6ack of application,notarized
<br /> ��, If.over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
<br /> ,,.. ;�...f.,,..�:�-;,
<br /> - Agent�(forth'e�conuactor)`orPower ofAttomey(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> :;;`�OVER�.THE�COUNTER-:PERMIT;T,ING, (copy_.of.contract,required) ' '
<br /> =Reroofs if sfiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> ` - ""_:.r"hY'u.':i^..:._..:-.,�-r..,_S..r...._.�....h.�;..a. .z .-,
<br /> Driveways-Not over Counte�;if on publie[oadways,:needs_ROW...•::�.,, �
<br /> r ...y':...,.�. � i��!i:i:.{i'.1i�1` •• • .�
<br /> ,'��~ :�,Y� . ..
<br /> �`�-•'..' �� ��.1�:�1��. i...•il.y...
<br /> �Yiii�i;.�4i.i v�..�iL�t.:�..,-:.. , ,. .
<br /> , . :0:.._ ...,.
<br /> ,i .<.�s :r,�...s—�y. ....r...,, �.: ,. _ .-.t.' '
<br />
|