|
-_ . ,-�_.r—
<br /> s�aaso-oozo � , City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � ` Bullding Department ��
<br /> S
<br /> Date Recelved � g ,,phone�Contaat for Permittin 3 13 (�
<br /> ; 9.. _
<br /> ' - �� �-- g�� r
<br /> Owner's Name �,�V� s��� ���� Owner Phone Plumber
<br /> Owner's Address v �� � " �� `'�-� �� _ Ouvner Phone Number a�3'' �G�� " � `�o�
<br /> . .
<br /> Fee Simple Titleholder Name • ^$ I,l( Ou'vner Pfione Number
<br /> , .
<br /> Fee Simple Titleholder Address �S�wI�, .
<br /> JOB ADDRESS �7� � -( v LOT# �
<br /> ;
<br /> ' SUBDNISION PARCEL ID# . - '
<br /> ,
<br /> � . (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> 1filORK PROPOSED ,. NEW CONSTR' ADDJALT [� SIGN Q � Q DEMOLISH
<br /> ' B INSTALL 8 'REPi41R .
<br /> PROPOSED;USE Q SFR Q ' COMM � OTHER e � e,
<br /> TYPE'.OF COfVSTRUCTION 0= BLOCK • Q, FRAME Q STEEL Q
<br /> i '�v�C` .,�' ��- �q ` " �.
<br /> DESCRIPTION OF WORK
<br /> i
<br /> i
<br /> BUILDING;$IZE SQ FOOTAGE HEIGHT •
<br /> ,_,. ,
<br /> QBUILDING $ ��,� , VALUATION'OF TOTAL CONSTRIJCI'ION
<br /> �,ECEC7'RICAL $ AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
<br /> QPLUMBING $
<br /> ;
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> _ � .
<br /> QGAS Q ROOFING- Q SPECIALTY Q OTHER ,
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER � COWIPANY
<br /> SIGNATURE REGISTERED Y/ N FEe cuwx�� Y/N
<br /> � Address , �Cicense#
<br /> 1
<br /> !``ELECTRICIAN
<br /> i;�� . COINPANY
<br /> ,�;: SIGNi4TURE REGISTERED Y/ N � Fee cuR�� • Y/N.
<br /> - Address ' - License# '�
<br /> �:
<br /> "r PLUMBER.;; . . . 'COMPANY�
<br /> , SIGNATURE �� � REGISTERED Y.-/ N. � FEE GURRE� Y/N
<br /> ;,: Address • .License# �- � �
<br /> ;:-'MECHANICAL " � COMPANY
<br /> -'�"SIGNATURE''' �` <' i ' � " � REGISTERED , Y/:N FEe Cuw�en . Y/N
<br /> ' Addre`s's��' � �• � � � License.#
<br /> ,;�i.�.,<t: .
<br /> F„•OTHER�� .",;� :�. - ` 'COMPANY �
<br /> ,-=��IGNATURE;:S;:_ *:Y � ' ' =REGISTERED ` , Y/.N FEE CURREA' ; Y/N
<br /> `tr:,��,,:�:i�,i"w , , , _ ._„ , . . . , � - . . - �- , - .
<br /> aaa�ass.-: - „�,. _ �•.�::x> _ ,� _ ci��se# �
<br /> a��
<br /> t-...� _ . �_ , � .. ._ . .. - _. - ;;.��;.,r._�•e.-�'. _ . , . . _. .
<br /> ;;-RESIDENTIAI:a�;; ��.AtCach�;(2);PI ( ):s ts�of BulidingsPlans;(1)°'sef of�Energy'Forms; �� w '��
<br /> � .s,:r: �,oi:.P..laas�•.2•Y e t� R=Q-IIV.Peririit�oc new.constiuction,
<br /> , . ., .. ...: ., � .. .
<br /> .:
<br /> '��� ^-.��:��.��4-��-��Minimum�;ten,�(1;Q);_,w,o�king3'day��;afterl"'s;utimittaGdate.`'Required'.onsite;"Constriiction`Plans,FStorinwater Plans w%Silt Fence insfalied;
<br /> ;.G �: '.`1:.`:':::�'.:S'.Y^S.�t" c:�r ...�u: r.l. . S
<br /> �:�•,.::,, , � Sanitary;Facilities,&�'I�:dwmpster:�Site.Wor,kPermit;for;subdivisionsAarge'proJects` �:.,, `'.. �_-- - - -
<br /> i,<,x,:._�, ._ . � ..
<br /> � COM�MERCIAL Attacti�(2)complete�'sets"of'Building Plans plus a Life Safefy Page;�(1)set of Energy Forms.R-O-W Permit for'new consUucBon.
<br /> . Minimum ten(10)working days after submiftal date. Required onsite,Construction Plari's,Stormwater Pians-w/Silt Fence.installed, � --
<br /> `�'� Sanitary Facil(des 8_1 dumpster.Site Work Permit fo��all�new�projects.All commercial requirements must meet compliance"
<br /> �:�;SIGN:P�RMIY '"Aftacfi"2�`sets.:Of; `��..�-- . `, . ,
<br /> (�) Engin,eered.Plans:>t����,":• �- ..
<br /> ���••♦�4- R���PROPERTY�8URVEY reguired.,,for,.aII,NEW const�ruction:_ �
<br /> ��. _ �.,.�,�<.:,_ _ ru ,
<br /> -:,Di'rectlons: , ., .,. ,3{: . ._
<br /> � `` <�F(II`:out'appltcaUon completely. Y�
<br /> ��� . O,wner.'8 Contractor:sign:back of application,notarized
<br /> ,., .,
<br /> � If over:$2500;_a Notice of:Commencement is required. (AIC upgrades over$7500)
<br /> `�="�- Agent�(for`ttie'�con�trac'to�)�or-Power ofAttomey(for the owner)would`tie someone with notarized letter from owner authorizing same
<br /> f•.. . - -
<br /> [�.; ,
<br /> ;:ANER':THE COUNTER;�PERMITTING., � (copy..of contract.required) " � '
<br /> �:Reroofs.if stiingles � Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
<br /> � � "D�i4eways-Not over Counterif on public'roadways.:needs ROVV• ���
<br />
|