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813a80-0020 City of Zephyrhills Permit Application Fair-813-780-0021 <br /> Building Department <br /> Date Received _ <br /> t Phone Contact for Permitting <br /> .Ella[a E a E a E E■ <br /> Owner's Name Robert&Janet Kustra Owner Phone Number 267-348-9300 <br /> Owners Address 15322 23rd Street Zephyrhills, FL 33542 owner Phone Number <br /> Fee Simple Titleholder Name I Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 5322 23rd Street Zephyrhills, FL 33542 LOT# <br /> SUBDIVISION PARCEL ID# 12-26-21-0040-00500-0150 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL = <br /> DESCRIPTION OF WORK New TPO Roof w/Insulation 4-OCLO Shin le l2ocyc u.)1Tear O;F <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> -ccccz-r'ccc-s-rsz-crca-rrctr�-r�t�cc>�ccccc>t c-sccrc-;-c�-s-cc�'cc�-r-�-rcq-cccrrrs'><s�-r <br /> =BUILDING $ 9,338.00 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E . <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ® ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE F REGISTERED I Y/N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN Y/N <br /> Address I License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN Y!N <br /> Address License# <br /> OTHER COMPANY A BBartlett Roofing&Construction Services,LLC <br /> SIGNATURE X REGISTERED I Y/N FEE CURREN I Y/N <br /> Address 38408 3rd Ave Ze h rhills,FL 33542 License# I CCC 1331965 <br /> ie�a>f[tec��[e�t®fa�����o�®ea[o�eeet�rfeti�a�aa®er�att�i��Eta�®[[® �assil <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,Stornwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsllarge 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/Sllt 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$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(PlottSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />