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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting — <br /> Owners Name Jerrys Crystal Bar Inc./Robert A Geddes Owner Phone Number <br /> Owner's Address 5713 Gall Boulevard Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 5713 Gall Boulevard LOT# <br /> SUBDIVISION PARCEL ID# 11-26-21-0010-03200-0030 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT = SIGN = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME = STEEL = <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ FOOTAGE 3368 HEIGHT <br /> =BUILDING Is <br /> h O o VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY 0. OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO. <br /> .. . .. :..ice .. . <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N I FEE CURREN Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N <br /> Address License# <br /> y o.e. <br /> OTHER PANY QII�IJOn�s�X(cvd�lQl� I V <br /> SIGNATURE REGISTERED Y/ N I FEE CURREN I Y/N <br /> Address LrA$ G" lis7p3 License 5 (.j <br /> 11111111111111111111 1111'111111111111111111111.111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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 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.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> —PROPERTY SURVEY required for all NEW 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 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 />