|
, a�aaso-oo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> • Building Department , ,
<br /> �.
<br /> .� �
<br /> Date Received 4�
<br /> i Phone Contact for Permitting � -
<br /> ' T � ��G o� 7)- 5 '7
<br /> Owner's Name �0�'� p"Ln � � Owner Phone Number
<br /> Owner's Address Owner Phone Number ���'"� �- ��
<br /> Fee Simple(Titleholder Name � � Owner Phone Number O��� ���-g� 6 � �
<br /> Y _ '
<br /> Fee SimpleiTitleholder Address
<br /> JOB ADDRESS 1�'l� �� LOT# �
<br /> y�
<br /> SUBDIVISION PARCEL ID#
<br /> ; (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B NSTALLSTR�B REPAIR � SIGN Q � Q DEMOLISH
<br /> k -
<br /> - PROP,OSED USE Q � SFR Q COMM Q OTHER '
<br /> . l
<br /> . TYPE'.'OF CONSTRUCTION Q BLOCK • � FRAME � STEEL Q
<br /> ; - ,� , .
<br /> . DESCRIPTION OF WORK �Q ���' IZ o 1 e i(� � (�-�
<br /> = BUILDING SIZE O CC e(�C10� SQ FOOTAGE IIJ� . � HEIGHT � l��Qi�1
<br /> �
<br /> ;
<br /> I �BUILDING $ 6-
<br /> : : s � VALUATION"OF TOTAL CONSTRUCTION
<br />' QELEC7'RICAL $ AMP SERVICE Q - PROGRESS ENERGY Q W.R.E.C.
<br /> i
<br /> QPLUMBING $
<br /> s
<br /> QMiECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> - y
<br /> � Q.GAS Q ROOFING Q SPECIALTY �] OTHER
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> - �
<br /> �
<br /> ;. �.BUILDER i ��� COMPANY ���n.�o �n e�
<br /> ' SIGNATURE REGISTERED Y/ N FEE CURRE� Y%N
<br /> Address �License#
<br /> i
<br /> . �, .,
<br /> ,�ELEC,,T,,RI,CIAN COMPANY
<br /> :.-'SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> , ;
<br /> „ �
<br /> . Addres,s Licerise# �
<br /> '� . F, .... r '
<br /> ;; PCUMBER.,x _ COMPANY- -
<br /> SIGNATUR� � :REGISTERED Y-/ N FEE CURRE� Y/N 1
<br /> - . e
<br /> Addres's � L(cense#'
<br /> , „ . � ,
<br /> ;�:MECHANICAL � COMPANY
<br />' ;,` SIGNATURE' "' ' ' ' REGISTERED , Y/ N _ ,r FEE CURRE� Y/N
<br /> _ ,,,� , .
<br /> ABd�es"s�� � � ' _ License# .
<br /> . ��•;��i,, , . .
<br /> �-OTHER� � � • ' -
<br /> I. - � COMPANY
<br /> �"'SIGNA:T.URE:•;�._ .� ' - REGISTERED Y/.N FEE CURREK Y/N
<br /> 1.�' •' ;4i . , � . . . .� '
<br /> � aadress.� - . 4 . r
<br /> ;. - .
<br /> Liaerise#
<br /> ��
<br /> ��.RESIDENTIAL.=?; ":Atta:ch;;(2)`PIot,P.lans;':'(2�):se't's�of�BuildingsPlans;'(1�)`sefofEneFgy�Forms R=Q-V11.Perrriit-.for new.construction,� .
<br /> ;� ,_ y;��4;:�,;.-,,-�.-�Minimum;tem(,,1Q).working?,cJaqs•,afte�su6mittal:date:'Reqiii�eii'onsite;Constriiction'Plans,�StormwaterPlansw/SiltFenceinstalled,
<br /> r,°,-,� Sarntary�Facilibes„&r,1.,;dumpste.r.•;,Site:.,W.orkRermitfor.:subdivisions/large.'projects� " ' - �
<br /> ;•;COMMERCIAL Attacti''�(2)�complete"sets�of'Building Plans plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructfon.
<br /> - Minimum ten�(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,- -
<br /> , '� `- - Sanitary FaciliUes&,1 dumpster._Site Work Permit fo�'all-new p�ojects.All commercial requirements must meet compliance
<br /> � :SIGN:PERMIT `AttacF►'(2)sets._of;Engineered:Flans:�f• �
<br /> ��= "'"PROPERTY SURVEY required for,.aII:NEW construct(on: �
<br /> .�. : .. -
<br /> _�.Di�ectlons: _.� ,, .. , � �
<br /> � Fill�:out applica6on completely.
<br /> '` 'Owner&Contra�tor sign 6ack of application,notarized
<br /> �,�
<br /> If over$2500,a Notice of:Commencement is required. (AIC upgrades over$7500) , ',
<br /> `""' A enY for'the'�donfracto��orPower�of�Attome fortfie owner would be someone with notarized letter from owner authorizing same
<br /> � 9 � ) Y� ` )
<br /> �-OVER.THE COUNTER`PERMIZTING� (copy..of contract=required) "`'� ""
<br /> 'Reroof§if shingles �Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) ,
<br /> :,�:,r,>�.:>>-x•,.,,;� - � - .r<��•� -
<br /> .. Drtveways-Not over Counter if on public roadways..nee8s"Rt�W' � " �``"�` �'' � '-` `� � ,j'"
<br /> � , -�,_. ..' ._t:',�.�i.. � . ?lIJ-. . ='.'li„�_ � . .. . ,:.. _
<br /> j ' � - � ��. ...��,.., .. .', � 'c! ..I'._.,.:.'f;.� . � , �
<br /> .� . '. ;-f_ ` , .�(1`: ' �'_._�,. .(t'i��'� - " _ .�. .
<br /> � '8' • ' . - . . ,�. . . . " ` � i� .i . n ,
<br />
|