|
sisaso-oozo City of Zephyrhills Permit�Application Fax-813-780-0021 /
<br /> • Building Department
<br /> �
<br /> ; ,
<br /> Date Received �phone Contact for Permitting � — �-
<br /> Owner's Name ., '��1 N C►a►� C {' Owner Phone Number �-1'' S ' ����
<br /> Owner's Address � f 1 � �G I�Jr,�O opcf Lp0 - Owner Phone Number
<br /> Fee Simple Titleholder Name P Owner�Phone Idumber
<br /> i ,.
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �� r I 7 �I e A d(3 W 00� L-6C �e, � �/)$ LOT# �
<br /> SUBDIVISION ���6�� ����T�S PARCEL ID# I✓� "' �o"' �'.d� �}C ` O0 000 p O ,�G I
<br /> s (OBTAINED FROM PROPERTY TAX NOTICE). !
<br /> WORK PROPOSED B . NEW CONSTR B ADD/ALT � SIGN Q � Q DEMOLISH II
<br /> ;; INSTALL REPAIR
<br /> PROP.,OSED USE Q SFR Q COMM 0 OTHER . e .z �r.� / i
<br /> TYPE=OF CONSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q I
<br /> �
<br /> 3 ti�
<br /> DESCRIPTION OF WORK � � �` � d J� �(D �al���� .�C �ei�G'e
<br /> BUIL"DING`SIZE SQ FOOTAGE .. d �� HEIGHT • Co � � `_�
<br /> �-o
<br /> QBUILDING $ �� VALUATION'OF TOTAL CONSTRUCTION
<br /> ,
<br /> .QEL.ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QP;LUMBING $ � � ���
<br /> �
<br /> �
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �✓ 7 ��� �jb
<br /> ¢ J
<br /> Q,GAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO /�"�
<br /> � �
<br /> BUILDER ; ��Jr' ��y COMPANY ����13'1 C�1 f�.��
<br /> SIGIdATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address foJ`�S L+�oa�I"�Ard l�(1v25�t'� (ti,�y.f z)
<br /> I �icense#
<br /> ,
<br /> . • }
<br /> ELECTRICIAN ,. COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> i
<br /> '� Address License# �
<br /> i - -
<br /> ,, . ,
<br /> PCUIIBBER�.: COMPANY �
<br />' SIGN14TURE REGISTERED Y•/`N• " FEE CURRE� Y/N
<br /> , -:�
<br /> i Address License#
<br /> , MECHANICAL' '� � COMP,ANY
<br /> ` SIGNATURE' REGISTERED , Y/ N FEE CURRE� Y/N
<br /> Add�ess=' - , License.# -
<br /> ,f;,.i^ ; � ,
<br /> ,.. :OTHER :: ' COMPANY
<br /> ''`SIGNATURE:t.i :' " � " REGISTERED Y/ N FEE CURREK Y/N
<br /> � ,;n:� ' . � , . '
<br /> � Addre'ss{<, - - - ' � - License#
<br /> ��_., . . : . ; .. ,
<br /> ;"`RESIDENTIAL��°� �Attach.'(2);PIof�Plan's;:'(2):sefs�of,Building�Plans;`(1�)'set'of�Energy,Forrri§;R=O=W Per'mit for new.construction, ,
<br /> " ••- ->_•:-¢;::•,--;:Minimum;;ten�(,1Q);working?days:after.'su6mittaGiiate.�Required�onsite;`Gonstruction Plans,'Sformu'vater Plans w/S(It Fence instailed,
<br /> Y..:-:;� ..� - ' �=� -
<br /> . San'itary;Facilities�&{c,1,;dumpster;:Sife;:Wor,ir Permit for;subdivisions/large`.p�ojects�- �- � � �
<br /> ;'.;COMMERCtAL AttacFr�(2)complete'sefs of'Building Plans plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permitfor new construction.
<br /> -- '_ - Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stormwater Plans w/Silt Fence installed,
<br /> ;;_,.. Sanitary FaciliUes 8�1 dumpster.Site Work Permit"fo�all new projects.All commercial requirements must meet compliance �
<br /> '::'$I'GN�.PERMIT -'Attach'"(2)`sets�of,Engineered P.lans:�c• ,. . � � '
<br /> *""PROPERTY SURVEY required fot aILNEW construction. �
<br /> `;Di�ections: ., .. _- . „ . • _
<br /> � FiIl,.ouYapplication completely.
<br /> I'� � Owner'&:Contrar:tor sign back of appllcation,notarized
<br />, If over:$2500,a Notice of Commencement is required. (A!C upgrades over$7500)
<br /> " Agent'(fo�th'e`•cont�actor)•or•Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br />, �;;OVER:THE'COUNTER:PERMI7TING. .(copy..ofcontract•required) ` � �-
<br /> Re�oofs if sFiingles Sewers Seniice Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drlveways-Not over Counter if on public roadways..needs ROW
<br />
|