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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ~- Building Department <br /> ~ Date Received I 813-460-7640 <br /> Phone Contact for Permitting <br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 <br /> owner's Name Owner Phone Number 8135165487 <br /> Owner's Address 35942 Saddle Palm Way Owner Phone Number N/A <br /> Fee Simple Titleholder Name I N/A Owner Phone Number N/A <br /> _ Fee Simple Titleholder Address I N/A <br /> JOB ADDRESS 35942 Saddle Palm Way,Zephyrhills, FL 33541 LOT# <br /> SUBDIVISION Silverado Ranch PARCEL ID#1 05-26-21-0080-00500-0030 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT = SIGN 0 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR COMM = OTHER I TESLA POWERWALLS <br /> TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL = <br /> DESCRIPTION OF WORK Installation of(2)Tesla Powerwalls <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $ 17,950.00 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE VP/OGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING 0 G/ <br /> u c <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO IIIYYYfffAI <br /> TESLA ENERGY OPERATIONS,INC. <br /> BUILDER COMPANY <br /> SIGNATURE 01(" REGIST Y/ N FEE CURREN Y/N <br /> Address 5012 Joanne Kearney Blvd Tampa,FL 336 License# N/A EC1300622s <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN Y/N <br /> Address 1 License# <br /> PLUMBER COMPANY N/A <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN Y/N <br /> 0 <br /> z <br /> 0 <br /> Address N/A License# I N/A <br /> E <br /> MECHANICAL COMPANY N/A <br /> 0 <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN YIN <br /> o , <br /> m Address N/A License# I N/A <br /> r� <br /> C� OTHER COMPANY N/A <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN Y/N <br /> Q <br /> o Address N/A License# N/A <br /> N <br /> r � rrrrtrtrl � I � II � � tI � IIIrfl � tt � r � � � � t � rl � I � if � IIIIIrrtlrrlltil � IrII1 <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 /> NMinimum 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 /> tO SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> m <br /> Directions: <br /> v' Fill out application completely. <br /> o Owner&Contractor sign back of application,notarized <br /> m <br /> LL If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> rn " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> m OVER THE COUNTER PERMITTING (copy of contract required) <br /> o Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROWsyrt. <br /> DocVerify ID:5D189590-F6BD4932-B8C6-6982779ASESA Page 2 of 3 1 26982779A5E6A I ,III rL�r,l II <br /> www.docverify.com -- -- - — &'r <br />