|
, .
<br /> - ��
<br /> ;. � �s���so-oozo �� j��,� � City of Zephyrhills Permit Applica#ion ��X-a1s-7saoaa�
<br /> � ' , t Buitding Department
<br /> t
<br /> 2 � , x. t 4-:tr ' i , i_ � . 1 Y�! n :•! - r '
<br /> Date Received `�`�'� J�t - . . Phone Cantaet for Permittin ' ` . " , . , . . , •"
<br /> {?w»er's Name Dcntt!/t/!f c_,,r/ ;� G-��S':'s . :.�.{;_ , - ,. ,,,� ,.` , : -: : ��',j��i I L,7�-D,�G U � .-
<br /> � Q L/ . Owner,Phane Number
<br /> Owne.r'sAddress� ,'`���7�'�2!�� �,��.%+�p�lS�'y��/�'� ���� ' �.. Owner,Phone:Number�, �l�'�?j�"�/ �/, ""_
<br /> FeeStmpleTitiehotderName,s ����!Q'i�.�r���U�`�-`�� c� � ` �Owner'PhqneNumber ,� � y� •
<br /> .;, :, � � ,.,.�,, , , �. . ,. , , , ,. .. -, , , .: .
<br /> Fee Simple Ttlehold`e`r Address'' �`�7���: ��cr;7j . ST;Z�,(5�,��1�7�/LL,.S t ilCt= =3`�5 �T Z ,i :r:.� , , -�. .
<br /> JOBi4DDRESs ' �S�l�}�+'�'� �Z:..v�'s `�•r�� ... _' =_ . = .:�,,., • � , - ...•; ., ,-, , , �.�oT'�� Ic�=�4�:y ,
<br /> su���u�isio��, � � . ,_ .� . ., - � �'� �p`ARCEL ID# � � ,. �� � . � , � � . „ r �_ , ,
<br /> , , , �, , , � �, , • ' . (OB7AINED FROM PRCIPERTY TAX NOTICEj . . ,. ;` ,
<br /> WORK PROPOSED � �,NEW CONSTR ADD/ALT, Q SiGN,'� � � Q.�_ ` DEMOEISH ' `
<br /> , ,t� ��, , , . , _�� ` t�tSTAL.C` � � �REPAiR � , ..�,..r - ,,. , ,� , t ., , .
<br /> PRQPOSED USE, . Q, , SFR , ,�Q; COMNl, �Q 4TIiEFi� _ �:S E: r
<br /> , . ,. , . ._ . , ,
<br /> TYPE OF CONS7RUCTidN' ti Q ,. ;Bf.00K ,. ;[�_ , FRAME, ,,.�y:� STEEL„ �° 1�.t>.;CC�itJC. `.Lr��. ..
<br /> DESCt21PTiON QF WORlC;. 'f Gl9MrS=i-/2c1:CT-.,��SA3��.L',;k3U/[_Jy�l�Gl� f,G9 !Uf t� ��,�,CS� , - ' .
<br /> :f� }: �,; :; • ;,,,;s. : , r
<br /> , ; , ;, m - • ,�_: ` � �_ . „ , � ,...., , ., .
<br /> BUILQING SIZE '�m���� r � SQ FOOTAl3E � �� `HEIGHT.,'-��«•r ; � . - � r � : ' �
<br /> �BUILDING �' . +i� $a`` � `��� ' " VALUATION OF'T07AC CONS7RUGTION ' � � . ': .' , ' , �„ , ,
<br /> , }< < , i ?t'� � � �_..�� �. , `f: ' � � r . ,. p �r b �. - `�
<br /> QEI.ECTRICAI.t $ . ' AWTP SEF2VICE',, �'r Q PROGF2ES$ENEftGY Q W.R.E.G. �
<br /> „ . . , :'� �. .. :_�� '.,. ., � ,. . ,� <<; � _ , , �. • �; , . � ,
<br /> ' � � • , � _ - , �•� �r; � ,�, = , , , , ,
<br /> QPI.UM8ING• .� $-:,� , , � . , , , . , ,. ,. . ,� i�� , . _
<br /> ,'-i 1 . , . :; �: �• - - -� .. i ' '�ii�t `.` . � - :#.5' -, `� t �� „ � � tif,l�"'''�.I .!
<br /> , t t,� .i .:.fs}:
<br /> QMECHANtCAt. $ � VA�.UATtt?N t7F MECHANICAL lNSTALLATIQN: .°, , ,v� �
<br /> , ? , ._ . . � ,�� ., ._i � , i E < < � , � � , ' , ��� .,
<br /> . �
<br /> QGAS Q ROOFlNG Q SPEGIALTY 0 OTHER ' ��� , �
<br /> ;- ,�-,,. . . .,
<br /> FiNtBHED�FlOOR EIEVATIdNS i .,, ' ,., FLOOD ZONE:AREA .., [�YES ' ; NO = , ;,,; �
<br /> ���� �y' i y 2
<br /> /
<br /> BUILDER � ���COMPANY, ` �
<br /> SIGNATURE REGiSTERED Y,/ N. , ; FEE CURREt� Y/<N ,
<br /> iAddress. r , .,:, , � ' . , .... . ,. , . , ,, ... ,:License,# �� � � �'�, � ' '�
<br /> , � � �,:-.
<br /> ELECTRICIAN. . , COMPANY : '� �� ' . . ;�= ,
<br /> i,� �. t� �I �` S,• '�U' ; , , a t.: ,� f ��
<br /> $IQ�IVATURE � ' REGtSTERED Y I N � FEE CURRE�" `. ,Y/N
<br /> �-. _ t�i _ � � - ,r li � , � `
<br /> `Addres's - � � . � ° �;t�, � sr ` • ' Lice�se# �� � . �
<br /> PLUMBER.-, , , , ,, ,.. ,. � , � �'GOMPANY � , '.� � , -:: ' ; .�' ,.. ,,;�; ;
<br /> $IGNATIIRE . ' ' '�';REGIS'fERED � ' ,t�Y/ N� ' FEE'CURRE���' ' �Y'/N " �
<br /> Address . ��. _. . .. . , . , �. . .. .. , ` , � P; -�� �' License# �r��t. � �� �
<br /> MECtlAi�i1GA4. . , ._� . , . �. � .COMPANY " > , .
<br /> SIGNATURE + :y �! � REGISTERED �� YL-N '.FEECURRE� Y%/%N. ,.; ; ��
<br /> `l t , � ' � � .. ' � ' _ � , f ,. � . � . , ,.t' ir � 4���tt � i . '.� , ;" . �,_ . , , � �
<br /> �Address - ;•.License#,.�,
<br /> . 1'_ .. ' ' � .� � !'� , ` ' �i ; !! �.._ ` ' . . , . ., . . � , ` � . f , ��{ ,. .
<br /> 07'HER a,� � ,. -� - • ,:_ �G4119PANY� .+ . -
<br /> SIGNATURE - � � _ REGISTEREd. , .r Y!.N ,F.EE CURRE� Y/.N , i
<br /> _ , �, ,�
<br /> Address, license# �� ����
<br /> , ,.
<br /> i t_�1,1�i,�,i, 1��i�i !,l,�i.�i,l.,i i,i;i� ! 1 f ,1._I ! �i'1,��1 ! l,�J 1 1 t t,.l-,1 I�,�t,l�,l.;��l,�;!'1�1�1 .1 1�1,l��1 1 _I.1 !_I i .1 �1 .1 1 1 ,LI .1 �1.1,Iti -.-
<br /> RESlD�N71AL: '�� AttacFi.{2)�Plot Plans;�',{2}�"sets of;Building Plans;.(1J set of Energy.Forrris;,.R-0-W Perrriit:fo�new con§fivction,� _ � �
<br /> Minimui'rr ten'(10)working days affer-submittat date:'Required onsite;Gons#ruction Pians,'Sformwataf Plans w/Silt Fence installed,-' =-
<br /> Sanitary Facitities&1 dumps#er;Site Wark Permit for sabdivisionsilarge ptojects , ` � r_'; ' ,
<br /> COMMERClAl. Attach{2)aomplete se#s of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. ,
<br /> Minimum ten(10)working.days,after submittal date. Requi�red onsite,ConstructiorrPians;Stormwa#er,Pians w!Silt Fence.instatted,_
<br /> Sanitary Facilities&1 dumpster.Sife tNaFk Perinit for aH new projects,RII commercial r+squirements must meef cbmpiiance' �
<br /> S!{3N PERMIT - Attach(2}sets of EnginEered,Plans. , - - " � ,. � ., .
<br /> "'"PROPERTY SUR1%EY required for alt NEW construction. ,
<br /> DlrecElans:
<br /> Fil�out application completely.
<br /> Owner 8�Contractor sign back of application,notarized � _ _ _
<br /> if over�250Q,a Notice af Gamr►�enaemerrt is required. (AJG upgrades over�750Q}
<br /> "* Agent{far the contractor)ot Power af AtEorney{for the owner)wo'uld be sorrieorie with notarized letter from owner authorizing same ` �} ' `
<br /> OVER THE GQUCdi"ER PERMITTlNG {eopy of cantract reguired) _ __ _
<br /> Reroofs if shingles Sewers Service Upgrades�A/C Fences(PIoUSurvey/Footage) ������ � ��' : �
<br /> � ����sa+i` .�',t:�
<br /> �it?fi�f J�'v'e;�'r'3 v�+iur,� >y
<br /> ��a q yN:`a�.
<br /> Driveways-Nat over Counter if an gubilc roadways..needs ROW � t��s� >�:,::. '�,�d
<br /> � talls?{j�"�If�q�"i'i'.::+�LtG'+iS����T _ "f�������' ..S
<br /> s f f>.,
<br /> � :i�+;f i� '-t '� .:u;.zr,!C�:f!d:sa . �;�y',�y'a. u4':{
<br /> p'i+;t}�,r i �JZ.?L:rt;�,r,= sft{t!L�i''ii�; ''� �Y v!��;� ],t
<br /> �� ',2 r�t'L`.�i'V':;>tl'il:. �l�qCfy��i.!'s;.i r,� ''�i:���t' ,
<br /> _.=�'r,'„+F'+.{t;v,�„ r:a..�'ra..;1•`'t'Vi%.*].;C,n��,::.4�: ,
<br />
|