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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 " <br /> IBuilding Department <br /> • ' Date Received Phone Contact for Permiltin <br /> Owners Name ��hn Lubbers Owner Phone Number 904-891-6240 <br /> 6102 16�h St-Zephyrhills,FL 33542 <br /> Owners Address Owner Phone Number <br /> Fee Simple Titieholder Name Owner Phone Number <br /> Fee Simple Titleholder Addres <br /> II <br /> ; JOB ADDRESS "'r O 0 16th St-Zephyrhills,FL 33542 � <br /> LOT�f <br /> SUBDIVISION PARCEL ID# 02-26-21-0180-00000-0710 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> I WORK PROPOSED B NEW CANS7R B ADD/ALT Q SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> I PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �G /`,�F U rl/��hL <br /> BUILDING SIZE S�FOOTAGE� HEIGHT � <br /> BUILDING $ ;y/)�� VALUATION OF TOTAL CONSTRUCTION <br /> /"I <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. �� <br /> QPLUMBING $ /1� <br /> � \ <br /> , QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> '�+",., RoofSmith of Tampa Bay,Inc. <br /> , BUILDER ,-� '�� COMPANY <br /> , SIGNATURE� ��_.� REGISTERED Y/ N FEE CURREA Y/N <br /> Add�ess 6089 Johns Rd.,Ste 9-Tampa,FL 33634 License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURREI. Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> ' SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> � MECHANICAL COMPANY <br /> � SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# <br /> , OTHER COMPANY <br /> ' SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> � Address License# <br /> IIIIIItllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll <br /> � RESIDENTIAL Atlach(2)Plot Plens;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new consVuction, <br /> I Minimum ten(10)working days after submirial date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence inslalled, <br /> Sanitary Facilitfes&1 dumpster,Site Work Pertnit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-0-W Permit for new construction. <br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Pians w/Silt Fence installed, <br /> � Sanitary Facilities 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Atlach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> I Directions:• <br /> � Fill out application compietely <br /> Owner 8 ConVactor sign back of application,notarized <br /> i If over 52500,a Notice of Commencement is required. (AIC upgrades over$7500) <br /> I _ � " Agent(for the contractor)or Power of Attorney(for the owner)woutd be someone with notarized letter from owner authorizing same <br /> � OVER THE COUNTER PERMIITING (copy of contract required) <br />' Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> � Driveways-Not over Counter if on public roadways..needs ROW <br /> � <br />