|
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 _
<br /> • Building Department
<br /> �<;�.,
<br /> 5
<br /> , � '
<br /> Date Received' 9`
<br /> • � Phone Contact for Permitting � —
<br /> Owner's Name �1v��h1 �(��/ f LV�Q�S� Owner Phone Number �1�"' ���'���D
<br /> Owner's Address ��?C��" T ���1�1J�� Owner Phone Number
<br /> Fee Simple`•;Titleholder Name � ��`��� Owner Phone Number
<br /> Fee Simple�Titleholder Address
<br /> JOB ADDRESS ���U�� �^ U���� LOT# �
<br />� t �J Q
<br /> SUBDIVISION PARCELID# `` �Z6'Z����� '� � 1��~���
<br /> (OBTAINED FROM.PROPERTY TAX NOTICE)
<br /> ' WORK PROPOSED B . NEW CONSTR� ADD/ALT � SIGN Q" � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> `s
<br /> � PROP.,OSED USE - Q SFR Q COMM 0 OTHER I
<br /> . TYPE`'OF CON$TRUCTION Q BLOCK • Q FRi4ME 0 STEEL Q
<br /> i r
<br /> �� DESCRIPTION OF WORK ����C`� ��✓�L� �lc�e wa,�.lc.
<br /> , BUILDING SIZE SQ FOOTAGE� HEIGHT :
<br /> t;.. i
<br /> - QBUILDING $ � - VALUATION'OF TOTAL CONSTRIJCTION
<br /> : g
<br /> ; QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �
<br /> �` QM�ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �V G •
<br /> .�=.' �
<br /> Q,GAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> �
<br /> � ,BUILDER , COMPANY �����L��iA/`�1.. �J�1�,�(�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y%N
<br /> Address `��Z—/�J/Z,T ��j/(� O �',� b��L�" `License#
<br /> i• ,�
<br /> f
<br /> ;:,`ELECTRICIAN . COMPANY
<br /> ...-�SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address - License# � �
<br /> �
<br /> P,CUMB�R.,,� CO�IPANY �
<br /> ;, SIGNATURE REGISTERED Y-/ N Fee cuRrteh Y/N
<br /> _, �- =';S� -" �
<br /> � Addres`s License#"
<br /> �,`":MECHANICAL � COMPANY .
<br /> _-';SIGNATURE'''`' �' ' REGISTERED Y/.N FEE CURRE� - . Y/N
<br /> , ;F,.
<br /> ' Aild�ess� ' r � � " License.#
<br /> ' �g•iEA.� � .,.._ _ . ._ . ,
<br /> �:OTHER.: "��. � ' COMPANY
<br /> '���SIGNATURE..:;n ,��
<br /> ;•�, ` - � - REGISTERED Y/.N.. FEE CURREK Y/N
<br /> � rPY: =(� . � , . � .. �
<br /> ���� Addressr:, - � � License#
<br /> � '
<br /> ' :RESIDENTIAL���;_";Athachr;(2)°PIot�Plaris;`�(2•)'sets of:Buiiding�Plans;'(1•j°sef of'Ene�gy;Forms�R=,0=1N Perniit for new.construction, �
<br /> r-__. . ... •- - �.., -
<br /> • -�,�Y�;,�y_:�-,._<:�-,Minimum;.,tenj(,10]working?.iJays'`afte�sutimittal=date.:Requi�etl�onsite;Gon`struction Plans;Sfor'mwater Plans w/Silt Fence installed,
<br /> _ �._ `Sanita;ry.;Faclli.tiesF8;r,1+;dumpste..r•,:Sife_Wor,k Fermitfor:§ubdivisions/la�ge=projects�- . : � � -
<br /> i�,`COMMERCIAL Attach`(2)`corriplete"sets`of.'Building�Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. __
<br /> '� Mlnimum ten(10).working days�after.submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> ;._,,,`,�. '
<br /> ;i� Sanitary Facilitles&1�8umpster.,Site;Work Permit foF�all-new-projects.All commercial requirements must meet compliance
<br /> i ;SIGN;PERMIT `Attacti(2)sets.of;Engineered'Plans:�:�'��� � .
<br /> � ,.��! ff}�
<br /> ��:.. PROPERTY SURVEY required for aII.NEW construction...
<br /> ��•- - -
<br /> i��;;Difec„tians: _ � ,_.-,-. , ,
<br /> �`,' F.ill:out�application completely.
<br /> `w?� p.wner`&.Contraotor sign.6ack of application,notarized
<br /> 4i",.
<br /> �: If over•$2500,a Notice.of:Commencement is required. (AIC upgrades.over$7500)
<br /> '':,..: ;..-t,�,,,,.::,..
<br /> , AgenY(for�th`e contractor)•or�Power'of'Attomey(for'tfie owner)would be someone with notarized letter from owner authorizing same
<br /> ;'OVER:THE COUNTER_PERMI]TING� _ ,(copy..of contract•required) -
<br /> �"Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> '} nt'i•�": ,';.:t!'%' ' " -
<br /> � Driveways-Not over Counte�'if on�pulilic'r'oadway",s..needs ROW , � I
<br /> - _.�.�..�i.;:i�r� ..�_r �t,- ,
<br /> � ,_..'��' .l'! . ._. ' ` '
<br /> . .:ar "jri; � ,� a �� ' ` .
<br /> � -.�il.,....._'J•�. � "! � r I
<br /> �4 +� . .. ......_v-_...... ' ..'
<br />
|