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I <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 i <br /> ^ Building Department i <br /> v.` i <br /> Date Recelved �0/6H5 Phone Contact for Pertnittin 813 234 Z4�9 <br /> Owner's Name �ackie Cook Owner Phone Number g�3-838-2888 <br /> Owner's Address 3801812th Ave Zephyrhills FL 33542 Owner Phone Number <br /> Fee Simple Titleholder Nama Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3801812th Ave Zephyrhills FL 33542 LOT# � <br /> SUBDIVISION PARCEL ID# 11-26-21-0070-06000-0180 <br /> (OBTAINED FROM PROPERTY TAl(NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT 0 SIGN Q Q DEMOLISH _ <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK equal 2 ton 14 seer ale ehange out <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ���1 . <br /> , � `� �� <br /> XQMECHANICAL $ 6,700.00 VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURREtv Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTEReo Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY Alr Masters of Tampa Bay,Inc <br /> SIGNATURE �D REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 4830 N Flortda Ave Tampa FL 33603 License# CMC1249497 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sels of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new consWction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Starmwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Wark Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new consVUCtion. <br /> Minimum len(10)woriting days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Wark Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construcUon. <br /> Directions:• <br /> Fill out application completely. <br /> Owner&Contractar sign back of application,notarized <br /> If over 52500,a Notice of Commeneement is required. (AIC upgrades over E7500) <br /> •' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />