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s�saao-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> . � Building Department �
<br /> Date Received ' � ,_ Phone Contact,for:Permittin Y �,.$ . , =21 . ''
<br /> Owner"s Name ' � " - � . . '�,.Owner.Phone Number. - `
<br /> Owne�'s Address 35 Sackanosset Cross oad Cran ton RI 0292 - 5 �: �.Owner Phone.Number, ° .
<br /> � � • , � , . . . , . .. . ; �: ; , . , �
<br /> Fee Simple T7tleholderName, . - - • � Owner Phone.Number •� •
<br /> Fee Simple TiUeholder Address ' ' ' � ' ' � ' �� ' � ' ' ' ' � -
<br /> JOB ADDRESS 5610 Gall Blvd Z h lulls FL 33542-3413 „ - , LOT# �
<br /> SUBDIVISION _ ' ,PARCEL ID# .11-26-21-00�10-05700-0255 �
<br /> _ . .�(OBTAINEO FROM PROPERTY TAX NOTICE) .
<br /> WORK PROPOSED NEW CONSTR .ADD/ALl' [� 1�,�SIGNt- ••;,Q,, ; ;,,. Q ;, DEMOLISW ,_ , .
<br /> . - :B � INSTALL 8 =,REPAIR, ; , . _.
<br /> . :; �,
<br /> PROPOSEDUSE ' �• • � • SFR : -_ �� �COMM ° . .�: _; OTHER� : � .
<br /> TYPE OF CONSTRUCTION • BLOCK - , ° FRAME '� � STEEL' � ' �
<br /> . ,-0 ,._�... _. . 0 . 0. , F . �. . ,
<br /> ' � � , .... '
<br /> DE3CRIP7'ION OF WORK Install a new roofing system.=FL#16039-R4� • � 's � � ' � - � � '
<br /> BUICDING SIZE ' ' � ' ' S4 FOOTAGE 2,400 ''��' ' °' ��HEIGHT � �: '�' ' • - .
<br /> �BUILDING ' ' $ � . ;•-VALUATION OF l;OTAL�CONSTRUCTION:„ 4 � , , ' r �
<br /> � ' 20,250:00 � - � ' "
<br /> � .,;, ;-- ,
<br /> QELECTRICAL ,:_ , $, , ,.AMPSERVICE., •, � , Q. ��PROGRESSENERGY Q W.R.E.C. ,
<br /> i L]PI:UMBING• ,.. ` $ , , V � . � ,.,,. - . . , - ^ . . � .
<br /> - < < , _ - , � , ' y , , ,
<br /> QMECHANICAL ` ' �� VAWATION'OF MECHANICAL INSTALLAl'ION: � � '
<br /> QGAS � ROOFING Q SPECIALTY Q OTFiER b��
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<br /> I FINISHED FLOOR ELEVATIONS _ FLOOD 20NE AREA' QYES��� � �NO �` ` � ' �-�j��
<br /> . . . . . . . . . . . -. . : . . .
<br /> SUILDER • nD COMPA Y �`^._ Z '� � . •� CD, � -
<br /> SIGNATUR l� REGI$TEF�ED - Y'/ N: T(FEE;CURRE� Y•/N .
<br /> Address- U ��iC '7 .,,�/.. L ��O� -' ' ,. i, `' ,/�Se`#: � . _
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<br /> ELECTRICIAN COMPANY ,� > -
<br /> SIGNATURE REGISTERED �Y/ N , Fee CuRttEn� Y:/N -,
<br /> Address � ` � . . - . , . . ' ,`License# �
<br /> ' ., . , ��+� _ �, - � ' , ' ' , : �. '
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<br /> PLUMBER. _, , . , � ,> ;r, ,..: , ., ;. ; COMPANY , _ ..... .. _._
<br /> SIGNATURE REGISTERED, A � �Y/�N_, � FEE CURRE� � Y/N
<br /> Address .. : „ . '`_ ' ' ' - ' �� . . . � ,Cicen'se# -
<br /> MECHANICAL ' . � ' '. ' � , > `.COMPANY �` .�'' -'' �• � " '`� • � ,
<br /> SIGNA7'URE �� - � `RE��srE'tieo Y`/' N� ' FEE CURRE� � Y/N � � �
<br /> Ad'dress. , . . _. . , __ i. , . .. �.: ( - ,� - . Ricense# ' ' ' , , ��
<br /> � .. , ,.. , , , . , . �� . . : . . . „ _ , . , , - .,
<br /> OTHER - • ' �-� - � � COMPANY' � ' � ` ;; '
<br /> SIGNATURE � REGISTERED��. ,,. �:� ;Y/!-N� �.,;_ FEECURREr ' Y/N " _ � - '
<br /> .. , ,. , _ _ ;i: - , �:. - . -� ' . ' ' , ' .
<br /> Address License#
<br /> � � � �i � � � i � i ���: � � i. � � � i � � � t � �;�:� � i .�. �,� i,�.i�� .� � r �:�-�-� �..� �_ r �_��.� � �:� � � � � � � � :� ��� �..� � � -
<br /> RESIDENTIAL Attach(2)Plot Plan,s;(2)sets of Building Plans;.(1�)set of Energy Forrns;R-0-W Pertnit�f,oc new�construction, = � ,
<br /> �� Minimum ten(10j�vyorking days after�submittal date.•Required onsite,Construc4ion Pl�ns,:Stormwater Plans w/Silt Fence installed,. ,
<br /> __, _ __—_ _Sanitary_Facilities`8��1 dumpster,•Site VUork Pe�mit_for subdivisions%large_�proje.cts_ , _� _ _ �_ � ____ __ __ ._,_�_ __
<br /> COMMERCIAL Attach(3)complete sets of.Building Plans plus a Life Safety Page;(1)set of Energy Forrns.R-O-W Permlt for new constnietion.
<br /> Minimum ten(10)working days after submittat date.. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence.insta�led,,_
<br /> -Sanitary Facilities&1 dumpster,-Site Wo�k Permit for a�l new projects.All commercia[requirements mu§t meet compliance , ,
<br /> � SIGN PERMIT Attach(2)sets of Engineered Plans: - :. � � _ -
<br /> `"*"PROP.,ERTY,SURVEY.required for aII NEUV,construction. ,. � , , . � � , � ,. ,
<br /> . . . . . , . . . . . . . . . . . . . , - . ..... . . . . . . . . . . . . .
<br /> Directions: _ ... _ . . - - - . . _ . _... .. __
<br />� . Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over�2500,a Notice of Commencement.is required.. .(A/C upgrades over�7500) ,�
<br /> '* Agent(for the contractor)or Power of Attomey(forthe owner)would be;someone with notarized letter from owner authorizing same _
<br /> OVER THE COUNTER PERMITTING (Front of Application Only)
<br /> Reroofs if shingles- Sewers - -Service-Upgrades A/C��--•Fenr.es(Rlot/Survey/Footage) -- - - _ ,. __. - -- -,r - • -. -
<br /> Driveways-Not over Counter�if on�publ,ic;roadway,s..needs R W � � , � - � � V .''I, , r,
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