|
813-780-0020 City of Zephyrhills Permit Applica4ion Fax 813-780-Q021
<br /> BuHding Department _ `''
<br /> Date Recelved — �'� — � � phone;Corilact foreFeecritttln ' �3 .�5 5 � 7 �a
<br /> z,
<br /> Owner's Wame �✓S}�n � Gh��S Owrner Pha�e Numaer �� 3' � �- ��4�.
<br /> owner's�►ddress �a-'S S �`sh I o�r+ � r�V �Z Owner Ph�ne Number � �
<br />� Fee Slmple3Title6older.Name � • � Owner Phone Number � �
<br /> y ` ,
<br /> Fee Slmple Tltleholder Addres�
<br /> t .
<br /> . L_��OB ADDRES8 0�r'�� a c LOT#
<br /> SUBDIYlStON � � PARCEL ID# � - '
<br /> i � , , , . (OBTAINED FROM.PROPERTY TAX NOTICE)
<br /> WORK PROPQSE� �.NEW CONSTR ADDlALT C'� SIGN' Q• ' �`Q DEMOLlSH
<br /> ' e, INSTALL �� ,,.REPi�IR
<br /> FRQPOSED-U8E Q SFR � COMM �� OTHEF2
<br /> TYPE OF CONSTRUCTiON � Q� BLOCK " [� FRAME C] STEEC Q
<br /> , -
<br /> � 1 .
<br /> DESCRIiaTION OF WORK (V�:�✓ �.,/0 e/1 C¢ b ��' h, h �Q -F� rJn
<br /> i
<br /> BW�DING SlZE' � � �'S4 FOOTA�E.� HEItiHT ��� .,
<br /> �
<br />, �BllI�D1NG � i'�S U , o o � VALt1AT10N'Ci`F TOl'A�.COiVSTRC'1CTIOi�! '. .. . -
<br /> ; � _
<br />' QELECTRIGAG. ($ '� AMFSERVICE Q RRt�GRESS ENERGY Q "W:R.E;C.
<br /> � � , ,.
<br /> , .
<br /> QPLUM81f+fG $ � . �`
<br /> � ,.Cl,,,,,,,� � � '
<br /> �.,
<br /> QMECHANlCAl. $ ` YALUATtON OF MECHANICAL INSTRLIATItON .
<br /> f �, �'. , , . ,
<br /> QGAS , CJ ROQF,ING ,Q SPECIA�TY C� , OT,HER� , --
<br /> FINISHED FLQOR ELEVATIQNS r�� FLOOD ZONE AREA QY�S ,NO �
<br /> � � - _ . � , _ .. . . . ,
<br /> ., . � , ,
<br /> �u��o�� ; caM�iar�nr .. ., . . ' �-�c��-�, o y�n e f' .
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� ' Y/�N':
<br /> Address ticense��� � �
<br /> � � , - � ' �
<br /> I EI.�C7RICIAt+1> - °COMPANY • `
<br /> �� SIGNATiJRE �' REGI37ERED Y/ N FEEGURREK`' `-`Y/N
<br /> ' , ,
<br /> Address " � . . . License# i�` ",'.�. �
<br /> i
<br /> ; _ .. _ , - � � .
<br /> PLUMBER " �COMP�W�' � t. " :
<br /> SIGNATURE' i' '" REGIST.ERED • Y Ir�N.t �FEE-CUFtREk Y:-/N:�-�:� x
<br /> - - k .4�.. . . . ' .
<br /> Addre�`s ` , . , � . _ .` + � ",.Ltcense#�� � `� ,,��:
<br /> , , fi..
<br /> 4 �. ' , _ . .- � ' ,
<br /> MECHANtGAL` • `COIiIIPAFtY . ,.. �t . - ' _ �
<br /> ,a , {,�._.. �•
<br /> SIGNATURE - '•' � � ' � REGI$TERED.,r: Y„/..N�., � FEECURRE��_ X;/�N �
<br /> ; _ �.' � ._. . :1�':,` . .� � �.
<br /> Addres's`-r , � ' -_. , ` . � + . ' . ` L'icense#
<br /> - :�.. .
<br /> ,•� . . - , �-�� . ' <.
<br /> 03HER '' � - � ` ',CONlPANY''
<br /> SIGN/1TURE' -.- , _ „ � -" . . ' „ ` Y REGISTERED`' ' ' Y/ N.:.. FEE CURRE� - Y/N -
<br /> Addr� , . _ f t ,. . „: , L`icense# � ' -, � �
<br /> i
<br /> -t„- ,.. �sk:�� r,.>,:: - , .
<br /> RESlQENTIAI:�;: , :Attacli'•"{2):Plot Plans;.,(2}set''s:affBullifing+'Ptans;(�)`seti:ofiEnergyrFoiins;'�R=O=W'Perinitfar new constccicbjon, � ,
<br /> �; �,,1:�.�Minimum,tern(1U);uvo.rking;days;ahe�;sub►iiiffai-date:r,Requi�ed onsffe;:ConstrtioBon=Plans,�StormwaferPians�w/SiIE�Fence instailed, '
<br /> � �Sani'tery FacillUes;&;;1jdumpster�8(te,�Woric;xP.ertnit fgr,sutidivisions/large projebCsw.;,�;;,.,c� :<'=-��: � . •�. . , , . ` �
<br /> CONIMERCIAI. Attach{3)'`compte�ke"sefs`of Buiiding Plans�ptus a'Life Safefy Page;�(1}set af Energy Forms.R-t>W Permi##or new canstructton. ���
<br /> Minimum ten(10j workfng days after submlttal date. Requlred onsite,CansUucHan Plans,Stormwater Plans w/Silt Fence installed,
<br /> Santtary FaciliHes&1 dumpster.Site Work Permit for all new.proJects..All commerctal requirements_must meet compliance `
<br /> SlGN PERMlT Attach{2}'sats oE�Englneer,ed%Ptaiis.,-4 :r;,.- 3' ',h - - . . -
<br /> ""PROPERTY SURVEY required,for aII.NEW construction. , �
<br /> Dltectlons: , - .. � � �
<br /> Ffll out applicatlan completely. �
<br /> Owner&Contractar slgn back of appllcatlon,naWrized �
<br /> If over��v00,a Nof�ce af Commsncament Is reqaired. {AtG upgrades ovar 57500) .
<br /> \� �•'' Y:J'tx;:��„��
<br /> Agent(for the�co�tractor)or'Power of Attomey(far tFie owner)wauld be someone with�ocarized letter from owner suthorizing same
<br /> OVER THE COUNTER,PERM11Tthlt3 ---(Front af-Rpp1lcatiaa•Only}- . ' �
<br /> Reroafs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Foatage)
<br /> Driveways-Nat aver Counter tf on public roadways'..needs ROW' _'�'�''-��""�_`�'�`:`�`Y`, � ' ` � . } �" '✓'
<br /> .w. ._. . b .•..,: ....... _ ... ...u_. ... —... J�.. .���..+ilr�. . ��..
<br /> - _i.1 "i,i: , ., .. , ... '.� ' „ C: . .":1 ,. �6ei."� i ,. �
<br /> 1� . , - ... � , <. .tti. ._. _ ,`t .. . `
<br /> ., ., . �1 .c ... .r � :l��, d�' . _ � � . � „ ' �
<br />
|