|
s�aaso-oo2� City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department �-
<br /> 1 -
<br /> Date Received Phon�Contact for Permitting - — �
<br /> Owner's Name �!N 1 " V V DY 1 Owner Phone Number �� 0
<br /> Owner's Address � � 1� V - Owner Phone Number
<br /> . � , ;
<br /> Fee Simple;Titleholder Name Owner Phone Number '
<br /> Fee Simple�Titleholder Address
<br /> JOB ADDRESS I J I LOT# �
<br /> SUBDIVISION PARCEL ID# I�' " V l �V V� �
<br /> • (OBTAINED ROM PROPERTY TAX NOTICE)
<br /> . �
<br /> WORK PROPOSED B NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOUSH
<br /> ,
<br /> INSTALL REPAIR
<br /> PROP.,OSED USE Q SFR Q COMM 0 OTHER .
<br /> TYPE`OF CONSTRUCTION Q BLOCK - Q FRi4ME 0 STEEL Q, '
<br /> i � �� ry
<br /> DESCRIPTION OF WORK V � • l •
<br /> BUILDING SIZE SQ FOOTAGE - . HEIGHT •.
<br /> -s
<br /> QBaU1LDING $ (�U , VALUATION'OF TOTAL CONSTRUCTION ,
<br /> > U
<br /> i
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> i
<br /> QP,LUMBING $
<br /> �
<br /> ' � i
<br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
<br /> 0 ; �
<br /> �
<br /> Q.GAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> (
<br /> � �
<br /> BUILDER ; COMPAIdY 2 �, 1
<br /> SIGPIATURE REGISTERED FEE C RRE� Y/N
<br /> �Address V "License# � (
<br /> { ,
<br /> ,� " ,
<br /> ; 'ELEC1'RI,CIi4N 60MPANY
<br /> - SIGNATURE REGISTERED Y/ PV FEE CURRE� Y/N
<br /> Address License# � �
<br /> PClJIVI BEIt.' COAfl PAPIY
<br /> � .�.-r ,
<br /> SIGNATURE - REGISTERED Y•/'N. FEE CURRE� � Y/N
<br /> s
<br /> Address - License# �
<br /> . _ � _
<br /> "`.MECHANICi4L , COMPANY
<br /> '�'" SIGNATURE'` ' � REGISTERED , Y/ N FEE CURRE� Y/N . �
<br /> : !.-, ..
<br /> Add'ress=� � Licens.e.# .
<br /> �,i(:-,,�� ..,. .
<br /> _. OTHER:=:�='�-� ' ` COM,PANY . .
<br /> :'SIGNATURE:S,:� . _ � • ' � ' REGISTERED Y/ N FEE CURREK Y/N �
<br /> Address;: _ -� • ' , � License# �
<br /> - f��ir[.s . . .•
<br /> T`�`.ARESIDENTIAI.iz�:, Attacfi:.(2)::PIot�P.laris;';(2)�sefs of�Building�Plaris;(1j`set'of�Energy:Forrr►s;R;O=W Permit:for new construction,.
<br /> _ ,. �--�:Minitnum;ten,(10)working;days.aftecsu6initta6clafe.�`Required<onsite;GonsViiction Plans;3tormwater Plan's w/Silt Fence installed,
<br /> <<>��< �� � ' � Sanifary,,Facitities;&;1,.dumpste.r:;,Site;Worir Fermit forsutidivisions/large'projecfs�-. - ' -
<br /> - ... •,,,.
<br /> ;:..COMMERCIAL Attach'(2pcoriiplete'"seYs'of'Building'Plans ptus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit fornew constn�ctlon.
<br /> - Minimum ten(10)working days after submittal date. Required onsite,Construcdon Plans,Stormwater Plans w/Silt Fence installed,
<br /> _ San(tary Facilities&1 dumpster.Site Work Permit foi�-�all-new p�ojects.All commercial requirements must meet compliance
<br /> :�r:�SIGN�PERMIT �AttacFi(2)sets,ofiEnglneered Plans:�� •�
<br /> :;:;-._.
<br /> ;,�,� """PROPERTY SURVEY.required for.all.NEW c:onstructlon.. .
<br /> ''.Directions: � .:t•,r�� .
<br /> Fill.out:application completely. ,
<br /> �_ O.wner`8 Cantractor sign back of application,notarized
<br /> � 1f over:$2500,a Notice.of Commencement is required. (AIC upgrades over$7500)
<br /> ..i.f�:i.
<br /> : "' Agent(for tti'e�contFactorpor�Power of'Attomey(for'the owner)would be someone with notarized letter ftom owner authorizing same
<br /> ;;QVER�:THECOUNTER,PERMITTING. .. ,.(copyof-contract,required) � "
<br /> Re�oofs�if�'sfiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) �
<br /> _ Driveways-Not over Counter if on public roadways..needs ROW
<br />
|