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DocuSign Envelope ID:676A329C-6359-4955-B5CB-C1061BD79052 <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Recelved - 0 3/2 8/19 I Phone Contact for Permitting 2 41-2 4 0 3 EXt. 1 <br /> -rrr r-rT <br /> Owner's Name Lawrence & Virgini:a Marchiniak Owner Phone Number <br /> Owner's Address 6905 Medical View Lane Owner Phone Number <br /> Fee Simple Titleholder Name F Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 6901 Medical View Lane,Zephyrhills, FI 33542 LOT# <br /> SUBDIVISION PARCEL ID# 02-26-21-0290-00000-0040 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT © SIGN Q 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL = " <br /> DESCRIPTION OF WORK interior renovation t0 an existing suite Including Arch., &MEP <br /> BUILDING SIZE F SQ FOOTAGE 2 569 sf HEIGHT <br /> ITI"ITrrITrlTI"ITITrI"T <br /> =BUILDING $213 000.00 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = P GRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ �/ t <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION { �' �' P\ 6u - l CJ <br /> =GAS = ROOFING 0 SPECIALTY = OTHER AJ0(f rQ <br /> rn <br /> FINISHED FLOOR ELEVATIONS. FLOOD ZONE AREA =YES NO <br /> :•-L-.-.. . . . . . .-1-. . . . :+t-:� . . .. . . .. . <br /> �• I COMPANY Precise Construction Inc. vJ <br /> E EGISTERED I Y/N FEE CURREA LY/N <br /> Address 5026 Trenton St T pa, FI 33619 1License#I CGC1514771 <br /> ocu rgne y: <br /> ELECTRICIAN o cu In' .'J/. COMPANY Alspach Construction&Electrical Co. <br /> SIGNATURE 6A r AS (MM� I REGISTERED I..Y/N FEE CURREI I Y/N <br /> Address 4 W B �ftT Tama Fl 33614 License# I EC0002854 r� <br /> PLUMBER his Q`�,t^ w1. COMPANY W.H.Alderman Plumbing&Heating Co. <br /> SIGNATURE REGISTERED I Y/N FEECURREp I Y. <br /> 0 OFB8E485z48F... <br /> Address 1755 Ua 1CO. a eland FL Llcense# CFC056821 <br /> eeuSigned <br /> MECHANICAL � � bvf COMPANY Florida Air Services <br /> SIGNATURE REGISTERED I Y/N I FEE CURREN Y!N <br /> F4 A04!✓E9C4 ' <br /> Address 7796 Fro�essionalIace Tampa,F133637 License# CMC124886 <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREDI Y/ N FEE CURREn I Y/N <br /> Address License# <br /> . 1'111111111111111111111111111111111111111-IIIIIIIIII11111.11111111.1111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Farms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work 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 construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.Ali commercial requirements must meet compliance .. <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> —PROPERTY SURVEY required for all NEW construction. <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 Attorney(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 />