|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Department
<br /> Date ReceiveEl ' _�
<br /> Tr�--�--r-n--�- Phone ContacYfor Permitting ��"��`�"�'"''�a'�or'�r--`E' ���-' � i'�°7'.�'��
<br /> Owner's Name � � �y ,� a •� - �
<br /> t"` • Owner Phone Number _ �LI[�. � ��
<br /> Owner's Address ���Q����� �ca ,n-, �,.� '�"� �' >�-�.�-
<br /> �'I°��J� :� �Owner Phone Number
<br /> Fee Simple Titleholder Name �„,.�, .�
<br /> Owner Phone Number
<br /> Fee Simple Titieholder Address
<br /> JOB ADDRESS �j , r �
<br /> � • + 1 `-t LOT#
<br /> � SUBDIVISION S f��, 1.���r'� �(� pqRCEL ID# -'�f�-�0--r�
<br /> --' n�'^ d�(�,
<br /> WORK PROPOSED (OBTAINED FROM PROPEATYTAX NOTICE)
<br /> �NEW CONSTR e ADD/ALT � SIGN � � DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE �� SFR � COMM
<br /> TYPE OF CONSTRUCTION ��' BLOCK � OTHER
<br /> Q FRAME � STEEL � •
<br /> DESCRIPTION OF WORK ��L'� ��� • �;
<br /> -� �rr',r�c•�'�-rv�Y �, �=�5�;?c�'c,-�� �� �Jc� , A��::I-�-1,� .��c�.�
<br /> BUILDING SIZE �/�,�
<br /> SQ FOOTAGE _�-�c � HEIGHT
<br /> To'rr��'r�-r-r-r�-r'r�-r�-�-r-�--
<br /> r"rrt-e-r-�-r-�-e-o-rr-f-9-rr-e-�-Q-r-r�-�-a�-u-'�-r-Q�-P-r-�
<br /> �BUILDING e-�-���_�
<br /> � $ � � (��;-� VALUATION OF TOTAL CONSTRUCTION
<br /> Q�ELECTRICAL $ - AMP SERVICE
<br /> �,�(�� � PROGRESS ENERGY � W.R.E.0
<br /> �PLUMBING $
<br /> , � r��j .
<br /> t
<br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> ��U�
<br /> �GAS � ROOFING �
<br /> SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS
<br /> I/� ! FLOOD ZONE AREA �YES NO
<br /> � V
<br /> -�-���--�o-���--a-°�°��''�'0�°'�-�-�-�-�--�-a-a-m'-Y-.a-.!-�-;•-�--l�I-t-O-a-.�:-p-E-:--a-l-4-S1-P.a-.a•-�•-a-P-:-�.-L�t,e��ta-�,a.-e-e4
<br /> BUILDER 4
<br /> SIGNATURE � �� - '� COMPANY � � _
<br /> � �-� ��-�,�, ��ti�
<br /> REGISTERED Y/ N FEE CURRE�
<br /> Address ����� %�/���� Y/N
<br /> /� r^ JG�r� �.- License# ���C>��=j� (6J ;�
<br /> .�LECTRICIA�1 � �.
<br /> SIGNi4TURE i'"'a'�'"� COMPANY ,( �,�`rj,Cyqrf��j'"r�',�3 ,��i'{,r,�..Z/l�..A �
<br /> • REGISI"ERED Y/ N F.EE CURRE� Y/N
<br /> Address 4�d,.��,j F'��0`"L's��(�,/r„� •�-
<br /> `�``�'�,'��� License# ��Q�,��c�����
<br /> PLUMBER �� �� /�
<br /> SIGNATURE -�`� — COMPANY ' /"r���,,t,(,?,� ,.����•`���.��� ������,�� �
<br /> REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � ���r ^�
<br /> ,� r���a- �,?�,�,� � d'�� �i' ,`'�. � `% ,�
<br /> "` � License# � � �
<br /> MECHANICAL �
<br /> SIGNA7URE � �:_..----��� COMPANY �"�A"�,f���`L,�'„(�,j"¢�,{��' �y�- ,f" s.,Js�
<br /> �REGISTERED � ' �� ����
<br /> Yr`/ N FEE CURRE� Y/N
<br /> Address ���-7� �GJ"��,� �x� 2�ra.�� t��L.`�`e:.r����
<br /> � �r• ,
<br /> License# ���������
<br /> OTHER -- - '
<br /> - �_A; .,--
<br /> SIGNATURE � , ^�-,.-. � �l��4"�,r�!'�/'��Jf'�/(� �/,-�,,�y'-%,,�.�
<br /> - - COMPANY �
<br /> REGISTERED Y/ N FEE CURRE�
<br /> Address '������f!�,� .� ,�/ � , Y/N �'
<br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 G ���ti, '�r ����
<br /> � � � � � � � d ; License#
<br /> RESIDENTIAL Attach (2) Plot Pla�s; (2)sets of Buil.�+ing Plans; (1)set of Energy Forms; R-O-W Permit for new construction,
<br /> 1 1 1 1 1 1 1 1 1 1 1 ➢ 1 1 ! 1 1 1 1 1 1 1 1 1 1 i 1 0 1 0 � 9 1 9 L@ ! B E B 7
<br /> Minimum ten (10)working days after�ubmittal date. Required onsite, Construction Plans,Stormwater Pians w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster;Site VVork�Permit for subdivisions/large projects
<br /> COMMERCIAL Attach (2)complete sets of Building��ians plus a Life Safety Page� (�)set of Energy Forms. R-O-W Permit for new con
<br /> , Minimum ten (10)working days after submittal date. Required onsite,Construction Pians,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facflities&7 dumpster.Site bVork Permit for all new Projects.All commercial requirements must meet com lianruction.
<br /> SIGN PERMlT Attach (2)sets of Engineered Plans.
<br /> '•*""*PROPERlY•SURVEY required for all NEW construction. P Ce
<br /> '-4"�_e"��- ------ ----- ---•--
<br /> Directions:
<br /> Fill out application com�te�y�.-1-.�p_�_��-�-d_�_p,�-�l�.�-9..�-.6�..�_�y�'�-&-0-�-�1�C..,.rg�p,�,�,¢�.�➢�&���.,
<br /> , Owner�Contractor sign back of application,notarized r
<br /> lf over$2500,a Notice of Commencement is required. (A/C�P9rades over$7500)
<br /> '"" Agent(for ttie contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authoriz
<br /> OVER THE COUNTER PERMITTINC (copy of contracr,required)
<br /> Reroofs if shingles Sewers �� ing same
<br /> ,ervice Upgrades A/�3 Fences (Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on�ublic roadways,.n¢:eds ROW , _ '' ' .�•�`t� ��, x � .
<br /> . . . . .. . . ; . . �- ,: . ,: . .
<br /> .., ,., ..�.. ., � , � : � ..,...- _ : - , . ,
<br /> _ �� . _., ,. . ,� , , � _ .�• :' .
<br /> r ., , . , , ., \
<br />
|