|
' oirrou-uu[u City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> Date Racalvad Q�� ��� – �Ol
<br /> Phone Contact for Permlttin O
<br /> Owner's Name U� 'fJ //7�/��,,e OwnerPhone Number �13`�d�����3
<br /> Owner's Address ��3�f l C)7'j6/�/�d� �L Owner Phone Number
<br /> Fee S(mple Tltleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRESS ��� �6/v�ppb l"�9L.E �
<br /> LOT#
<br /> SUBDIVISION �/QI��(�� Qa a
<br /> � ��S PARCEL ID# � o`ZI D�l B Q���ff� ����
<br /> (OBTAINED FR�OM PROPERTYT�7�CE)DEMOLISH
<br /> WORK PROPOSED , e NEW CONSTR ADD/ALT � SIGN
<br /> INSTALL REPAIR
<br /> PROPOSED:USE �] SFR Q COMM [� OTHER
<br /> TYPE OF CON3TRUCTION [� BLOCK ' [] FRAME [—� STEEL � ,
<br /> DESCRIPTION OF WORK L���-'o �`C e� o� �°NT pG �"�/�f �j �`�
<br /> BUILDING SIZE SQ FOOTAGE
<br /> HEIGHT .
<br /> QBUILDING $ .
<br /> . VALUATION OF TOTAL CONS7'RUCTION
<br /> QELECTRICAL $ - AMP SERVICE
<br /> Q PROGRESS ENERGY [� W.R.E.C.
<br /> OPLUMBING g _
<br /> MECHANICAL $ ��� VALUATION OF MECHANICAL INSTALLATION
<br /> �. �� ..
<br /> QGAS Q ROOFING _Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA
<br /> QYES NO
<br /> BUILDER
<br /> SIGNATURE COMPANY
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address
<br /> License#
<br /> ELECTRICIAN
<br /> SIGNATURE . COMPANY
<br /> -�
<br /> REGISTERED Y/ N FEE CURRE� � Y/N
<br /> Address
<br /> Llcense#
<br /> PLUMBER
<br /> SIGNATURE COMP..ANY
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address
<br /> -License#
<br /> MECHANICAL � COMPANY /�
<br /> SIGNATURE ��� ZQ� l�}'/�/Q S /'Dpf�/�/���r—H�T�/�
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �� � �7`�E'/J /�. ,�,`�.�lf6S 3,�$SL/ License# G/�� ���' jn�
<br /> OTHER
<br /> SIGNATURE �COMPANY
<br /> REGISTERED Y/ N . FEE CURRE� Y/N
<br /> Address �
<br /> License#
<br /> RESIDENTIAL• Attach(2),plof Plans;(2)sets.of�"Buildi"ng`Plans;(1)set of Energy�Forms;R-O-W Permit for new construction,
<br /> Minimum:ten(•1,0)working;days,aRer„submittafdate. Requlreii onslte,Constniction Plans;Stortnwater P ans wlSllt Fence installed,~
<br /> -- -- - SanitaryFaciliUes:&-1,—durripster-Site�WorktP,.ertnitforsubdiv,lsionsAa e roects �
<br /> COMMERCIAL Attach(3)complete sets of Bullding Plans plus a Ufe Safety Page;(1j setof Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submithal date. Required onsite,ConsUuctlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new projects.All commerctal requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered;Plans.
<br /> ""PROPERTY SURVEY required for all NEW construction. .
<br /> Directlons:
<br /> Ffll out appllcatlon completely.
<br /> Owner 8 Contractor sign back of appltcatlon,notaAzed
<br /> If over b2500,a Notice of Commencement is requlred. (A/C upgrades over 57500)
<br /> " Agent(for the contractor)or Pbwer of Attomey�(for the owner)would be someone w(th nota�ized letter from owner authorizing same
<br /> DVER THE COUNTER PERMITfING (Front of ApplicaUon Only)
<br /> Reroofs if shingles Sewers Service,Upgrades•-NC.-.,r..Fences.(PlodSurvey/Footage) ,.,�.,�...:
<br /> .. �.. - �7.� � ..C...�L .,.
<br /> , , . sTa�.fiE. "' '... . ' � _'"......''
<br /> Driveways-Not over Counter'if on public roadwa f, ` ' � `' " ;
<br /> ys..needs ROW , .
<br /> :, - . .� � .
<br /> `�._ _.th. .,. , ,. ,u .�, . ,. ,.,, j � � ' ' . .. " . , .
<br /> -.:2.,.�1vnF.y..y.-.:. , mY"wu.r"t_
<br /> .•'�cy..,y.�,....r..��,..__. -.... �, ; __
<br /> � . � 1
<br /> f��:
<br /> " _".� .:..._✓' _" '.�,. ... ..+' , .
<br /> ; (
<br /> ,__`__ ' ,- . '.r.-:w.:. _ . �
<br /> .._.._...__.'_ _.__'__ .. ... �,. � ......_ ....n-..
<br /> .........__...�...___.._ .... _ .. '.u.+..�., • - v i ...r-s
<br /> _'__-.e _`"' __—_ ...m__..........:.._"__.___�__ . �...v r-a _ -_:.d�.a.+���-e.u�v�.r.. �
<br />
|