|
8��-�saoo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> . Building Department
<br /> Date Recelved }. ' . ;: Phone':Contact�:foc�Permittin -
<br /> Own�r'a Name �iL V L� �P L L� Owner Phone Number �-Z��'� �z��
<br /> Owner's Address �3b l���tyT2Al s 7� . F L 3z�o( Owrner Ph'one:Number� ~� i
<br /> Fee Slmple TItIeHolder.Name � � � � - Owner Phone Number � I��
<br /> .�. � �
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDItESS 3�?��P �AVG b+��i�'� �. L�p�j �(4� F'/ $j��0 LOT# �
<br /> susoivisiow � e���P'/� � OAKS (Z✓ . � ��ce�.io� �3S'- ZS-2.f-Golo—/zG a� = oo�
<br /> � (OBTAINED FROM.PROPERTY,7AX NOTICE)
<br /> WORK PROPOSED •�NEW CONSTR' ADD/ALT � SIGN' "Q ' Q DEMOLISH
<br /> :,8; INSTALL, � '. REPAIR � �
<br /> PROPOSED..U$E . Q SFR• �] COMM' : Q � �OTHER - ' �
<br /> TYPE OF CONSTRUCTION"� Q` x>'BLOCK " Q FRAf�AE ' .� 'STEEI `Q '
<br /> .. .� rl.. , -. . �� -
<br /> DE3CRIPTIOTr OF WORK' � ' NS��4<I C A��AC� UN e r �'%rrn -
<br /> .} ..:
<br /> BUILDING'SIZE'� .�. .' SQ`FOOTAGE '��s�p. ; ..HEIGHT ..
<br /> „: - -
<br /> QBUILDING $ VALUATION�OF'TOTAL COySTRUCTION ' '
<br /> QELECTRICAL' $ , " AMP SERVICE. ' Q �PROGRESS ENERGY Q W.R.E:C.
<br /> OPLUMBING - $ - � �
<br /> . , . - . _: �, _ : = .� �� � � -
<br /> �MECHANICAL' . $ ��DD e�o "' �"VALUATION OF{MECHANI.CAL INSTALLATION., �
<br /> []GAS �] , ROOFING Q; ;, SpEC1AL'lY;::�],.>,.,,;OT.H�R�, , _
<br /> FINISHED FLOOR ELEVATIONS FLOOD zONE AREA ,QY�B. .NO
<br /> .:... : � , .:. ��,s - • - - . ,
<br /> ,Y. ,,s _«�_.,,�-. t•;C:` -.F�."{,, - ' _
<br /> BUILDER COMPANY�` '.; - � �..��.�`=�.•• - �: . • - - � �
<br /> SIGNATURE REGISTERED Y/ N . =`�''FEE CURREP?" ' ' " Y 7'N '�
<br /> � .;l'.. 'i=f.y . - ',t'?, . .. , ... . . , .
<br /> Addre�s - �� ,;= - . ��•; � :License#� -
<br /> +: � .
<br /> � .._ � .,. . � � • �. -r. y; :�r, . " �' _ _> .- „ ... _. , .. — .. , ,, � ,
<br /> ELECTRICIAN: • . � - _ 1_tCOIIAPANY' i �:`� �°� '?;,''�.° �:';`, _ a � :r -
<br /> SIGNATURE � ' '' � ���is�REo ,� Y/ N I :Y �:curu�����°Y;��-Y/:N=� ` _ ,
<br /> ' . , y� , - ' -`.7 ^?;'rl':�, a'� =.:'. ;=; l.•<. �.. . �r. � ,. � - ,
<br /> Addre� . ., • _ . .. , , �,r�: . ,
<br /> -- . , - . ia .s.TLICenSe_#�: - �
<br /> L .. , • . _ - . � , -. ..... . . .. . . . . .
<br /> P UMBER ,C.OMPANY � . - . . , ,.. � ,
<br /> . . , . ,�. ., ,.. , _, .•i:", ... , .
<br /> zti .i . . _., . �, � , � -
<br /> . ,�• . . :,.. _
<br /> .. 'r��:
<br /> SIGNATURE°�` � _ , 'REGIS.T.ERED :Y.:/,:N:s . �FEE-CURrt��t� ,; Y-;/_N�-- .
<br /> _ - � - _ �::> .. _ • ,_ �� - _.- .
<br /> Add . ' , _. ' - - .
<br /> ress
<br /> H ., n -,.,. , . -
<br /> . �u. `8 . . ,
<br /> .;. _ .
<br /> ., _ , ��S�E# ,
<br /> � ,��� .. . �. : _ _ ,
<br /> +
<br /> MECHANICAI:i � . - - � �oMP� � -so�;�Nys D��c�=Nb:qP��;��c=fs.
<br /> SIGNATURE� , :z' ' ,: � �_ '
<br /> ` ��isTEii�� � .Y„ ,N ; ,,5:,��CuriREn.. Y �N
<br /> AddY688'"r=x`I�'�o�� ��y''��l:���: ...��7/QDE %ti1� ��5� ' . . . LIC9�1$e#`" �... �%'7 �7��
<br /> :c�.
<br /> . ,:�: , . . _ , . ,. , .. _ - ;.. . .
<br /> _ �, _ � , n . .:� ,,,k,. :;f _;.: . _ , < <:..�r . . .. , , . ..
<br /> OTHER ' ., .. �- _ .. .. �` ;COM,PANY> _ .<: ..... _ ,
<br /> SIGNATURE• ,. ':.° ';p' - <? ..-., ; , _ . � :`� 'REGISTERED' " � Y/'N:..: �" ��e Cur��:•�_ Y'/N
<br /> ��:i•�.,:ra... �: : . . _. :� .. ' ' ... _ __ . . ... - ' •" ... , r,.. . � _
<br /> .... . ,... ...: .�..:�..
<br /> ...F:�f�.� i -.ti .5 , ..._.. ,
<br /> zr ,�,��y�,r,..�'y �eC;�-'''��' • •} :.<{."„ ' ' '1 , ' " " ,._
<br /> Addre� ;;.� - �:b:.,,•,; � _ . . • .°Ucense#�� ' . . .
<br /> r-� , . � _ �r�::� �<:f<:t c;. �;,._:.,�. : ,. ;.�.;,. ..t�.:�. ,t s..,.. ,.;
<br /> RESIDEN7IAL;;;�,��Attaoh�.(2);P1:ot;Plans;;(2)set`s:of8u6dtng�:Plans;{:1�)'set'of�Energy Forrins;FR=0=1N=Pertnit fo�nevu��nstnicU,on;�. " � � .
<br /> ' ' 'r�^ i" :V�'��1'.n. .-� .. .�...K�.�.. �R'.v� t t-�n ,�.:.�...... _.
<br /> -�-�����;,�Minimumk•�enr(t10)uvo,rlSing;da�ys�aRer�"submlttal:d"ate�.:R'equlretl onslte;.Con'stitictlon:Plans;•�Stoimwate�`Plans w/SIIt Fence instelled,
<br /> �San(fary Fac111Ues�&;;13�dumpster��Slte•�Work;Permit�for;sutid(vislons/lerge.proJ'egts;.�>:�"=;i;��` '� `_';'_ _. " :��:
<br /> CONIMERCIAL Attach 3�oom`lete�sets°of'Buiidiri``'Plans��lus"a�Ufe Safe`��Pa e; 1 set of Ene Fortns.R-0-W Permit�for neW�consUucUon:- - "
<br /> � ) P 9 P tY 9 � ) V �9Y
<br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sllt Fence instelled,
<br /> Sanitary FadliGes 8 1 dumpster.S(te Work Permit.for all ne4irproJi�dfs:::All commercial.segulrements_must meet compliance"`� �
<br /> . SIGNPERMIT Attadi(2)`setsof"Eng,i'neer,ed;,Pla�s:,�:�.,.:;s:?.�=- . �., ., >_. . _ ._ -• . , ,
<br /> ""PROPERTY SURVEY required for ell,,;_,NEW construcUon._..._ _. ._ _. .. -. - -
<br /> Dl�ection�c ..r.=�.�~��~,.. .._ ...,. _
<br /> FIII out appltcatlon oompletely.
<br /> Owner 8 Contractor sign back of applfcatlon,�otadzed
<br /> If�over�t500,a,N,otice;of Commencement la rsqulred. (AIC upgrades over s7500)
<br /> .. ���.�:tr'��,i;,:,:,Jr.
<br /> qgeM(for the oontractor)o�PoVfre�`of Attomey(for the owner)�would be someone with notarized letter from owner authorizing same
<br /> ,.... - .. , , , ,
<br /> DVER�THE.COUNTERvP.:ERMITTING-�-•-•�:��•(Front�of-Appltcation-0nly) -�-- '
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> :';,;s�,.,... �, �.: - , �.. . .,..� . - ' - -
<br /> Drlvewaya-Not over Counter if on public roadways..needs ROW
<br />
|