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813-780-0020 City of Zephyrhills Permit Application Fax-813-760-0021 <br /> Building Department <br /> Date Received phone Contact for Permitting (813) 85-4440 <br /> Owner's Name George Varghese Owner Phone Number 813-312-1298 <br /> Ownerss Address 794 Klondike Avenue,Staten Island,NY 10314 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 1 3773314th Avenue,Zephryhills,FL 33542 LOT# 23 <br /> SUBDIVISION Downs Addition to City of Zephyrhills PARCEL ID# 10-26-21-0600-00000-0230 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT = SIGN 0 = DEMOLISH <br /> X INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM = OTHER <br /> TYPE OF CONSTRUCTION ® BLOCK Q FRAME = STEEL Q <br /> Reroof slope roof 5:12 pitch,25 Squares-Certainteed Shingles FL5444-R15 Peel&Stick <br /> DESCRIPTION OF WORK Undedinnent FL25974-RO <br /> BUILDING SIZE SO FOOTAGE u-HjjEu HEIGHT <br /> ®BUILDING $ 8355.00 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL Is VALUATION OF MECHANICAL INSTALLATION <br /> =GAS QX ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LYLN <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 CURREA I Y/N <br /> Address I License# <br /> OTHER I COMPANY Nations Roofing,Construction&Mechanical,LLC <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREN Y/N <br /> Address 16421 Bellamy Bros Blvd,Dade City,FL 33523 License# FCCC1331419 <br /> IIIIIt111i11tIt111111i111111111111111111111111111111111111111111111 <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 subdivisionstlarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forma.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constriction 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 /> Directions:• <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2600,a Notice of Commencement Is required. (A/C upgrades over$7600) <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 />