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_ 813-780-0020 City of Zephyrhills Permit Application Fax-813-7e0-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting ( ) <br /> Owners Name Paul Simard Owner Phone Number 8�3•,�?'• LpllDl <br /> Owners Address 5023 6th St.Zephyrhills, FL 33542 owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 5023 6th St.Zephyrhills, FL 33542 LOT# <br /> SUBDIVISION PARCEL ID# 11-26-21-0010-19000-0080 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR Q COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL = <br /> DESCRIPTION OF WORK Ac Change Out 3 Ton 14 Seer HP 5kw&duct for duct change out <br /> BUILDING SIZE I SQ FOOTAGE HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> ©MECHANICAL $/A, r ® VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address I License# <br /> MECHANICAL COMPANY Ac GuyZ, LLC <br /> SIGNAT REGISTERED Y/N FEE CURREN Y/N <br /> ss License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> 11a1a.[![[[1[[[[![[11lIf-•11_1Saa a a I I <br /> l.l1!![I[[■[!Its <br /> IaI S-1aI.il.!'al.!1!.[:1aI <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 Fortes.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$2600,a Notice of Commencement is required.(AIC 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 />