|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department .
<br /> ; - .
<br /> Date Recelved . � Phone•Contact for Permittln � � O 1
<br /> Owner's Name l�e J O Owner Phon�Number �( — 1 7 I'��� �
<br /> Owner's Address �V I ��-- I(�� Owner Phone Number-
<br /> J * i
<br /> Fee Simple Tltleholder.Name 0/�t� / S z� ��'l. Owner Phone Number � �
<br /> Fee S(mple Titleholder Addresa �O 7� , fiu � � , � � � �``�. �
<br /> JOB ADDRESS O � � ��� S T LOT# � i
<br /> SUBDIVISIOPI PARCEL.ID# ' ' I
<br /> � (OBTAINED F.ROM PROPERTY,TAX NOTICE) �
<br /> WORK PROPOSED �.NEW CONSTR' ADD/ALT Q SIGN Q Q DEMOUSH '
<br /> �-B, INSTALL B .REPAIR ••, '
<br /> PROPOSED�USE � Q SFR. Q -COMM Q OTHER � �
<br /> TYPE OF CONSTRUCTION Q� � 'BLOCK " Q FRAME � Q ,STEEL" 'Q �
<br /> - �� , � /� // //
<br /> DESCRIPTIONOFWORK' , � /�,. I (=f"t(��l' /(L'��` DI1 � � s't � p � I
<br /> . �
<br /> BUILDING SI2E'' � � �'SQ'FOOTAGE�, - . HEIGHT�, li
<br /> QBUILDING $ VALUATION'OF TOTAL�CONSTRUCTION
<br /> QELECTRICAL $ ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. '
<br /> �PLUMBING $ oc� � '
<br /> ��
<br /> QMECHANICAL . $ VALUATION OF MECHANICAL INSTALLATION
<br /> - i
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER - �
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO I
<br /> - i
<br /> BUILDER COMPANY�`
<br /> SIGNATURE REGISTERED Y/ N 'FEE CURREA Y/N
<br /> � i
<br /> Addre�s ' � � Liaense# - ,
<br /> i
<br /> ELECTRICIAN; ; � - y`=coMP,�„r �w N�P�
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� ' Y/N
<br /> ' I „ y ,
<br /> Addre'ss ' �� ,.- License.# �
<br /> PLUMBER'_ - COMPANY �S ;; . ���- �.C/�Yj`LU N�
<br /> SIGNATURE'` � - � , REGIS.TERED,. � Y.l.N. . ; FEE CURREA. :; Y•/N � I
<br /> Address t� 7 (..�Gt' � U ��r 4'�5 � License.# 02 � I
<br /> ,�. . � , , , .�
<br /> MECHANICAL' ' " " . COM,PANY. • -, �
<br /> SIGNATURE � �- ' � REGISTERED , Y./ N . ,_ FeE CurtREn Y./�N �
<br /> ' �Y'l`' � . ... ,.. . �
<br /> Address' .�_ �''� � - � � . =��° _ .- . , ' - , ' ` License#� ',
<br /> : ; , . .� ,
<br /> OTHER .= . - ` _ � � . ;COMPANY' .., .. ., � I
<br /> ;,.,--„ ,;>_., , ;.
<br /> SIGNATURE' �;• " • '' �REGISTERED� ' Y/'N..r ' FeE cuR�� Y/N �
<br /> Address '�f`�� .. -y � , " - � Cioense#: � - -
<br /> !' ' " " ' '� . .`tj,::,. ' -. ,5v.._�.,:cr '. ' a ., _
<br /> RESIDEN'iIAL:t,.�.;Attacfi°(2);P:,lot Plans;.:(2)sef`s-of�Buil'dingi Rlans;`(1)set;of.Energy;Fortq's;.R=0-W'Per`rriif for new,construction, � � .,
<br /> � ;-,.,:, -. ;-:.,_, .
<br /> ; ;�,:Minimum;ten;(;I.0);worfcingsdags,after,submiftal"date::Requlred onsite;::Constii�cdon-Plans;Stormwater Plans w/Silt'Fence installed,
<br /> � ' Sanitary Facllttles 8�1 dumpster,3lta�WorkrP;ermftfor sutidivisionsAarge.proJects_ `..-,,:'�.,• _ � � �. '• - -—
<br /> �COMMERCIAL Attach(3)oomplste'seCs of Building Plans plus a'Life S'afety Page;(1)set of Energ�y Forms.R-O-W Permit fo�new canstruction.
<br /> Minimum ten(10)v+rorking days after submittal date. Requtred onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides&1 dumpster.Site Work Permit for all new�projecfs::All commercfal requlrements must meet compUance '
<br /> �SIGN PERMI7 AttacF9"(2)"sets of�Engirieer,ed�Plans::. •:-= 7 �.•; :� � .•- � ' `
<br /> ••••PROPERTY SURVEY reguired for,all NEW construcUon.. .,.
<br /> Dlrectlona: :°�t���'` ', � �
<br /> Fill out applicaUon completely.
<br /> Owner&Contractor sign back of appllcaGon,notarized �
<br /> If over 52500,a Notfce of Commencement Is requfred. (AIC upgrades over ST500)
<br /> " �,...t.�.:.
<br /> " /\qent(for tFie cantractor)'or'Power of Attomey(for tFie owner)would be�someone with notarized letter from owner authorizing same
<br /> DVER'TNECOUNTER:P..ERMITTING ---:-(Front�of-AppllcaUon-Only)- �- - � �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage) ,_
<br /> Drivewaya-Not over Counter if on public roaduvays:.needs ROW �
<br /> � f
<br /> � �
<br />
|