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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 (813)7274,072 <br /> t 1 1 1 1 1 1 <br /> Owners Name Carolyn Niselyender Owner Phone Number 813-355-3401 <br /> Owners Address 37348 Derb}•.•hire Ih•.'Leph%rhills.Fl, 335J2 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 37348 Derbyshire Dr.Zephyrhills,FL 33542 LOT# C <br /> SUBDIVISION 11.1.;uc1sN1•ooD nlallolt PARCEL ID# 10-26-21-0120-00000-0990 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NewcoNSTR ADDIALT = SIGN = = DEMOLISH <br /> = INSTALL = REPAIR <br /> PROPOSED USE = SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL = <br /> DESCRIPTION OF WORK Replace Size For Siee 8 Window(s)-NON-Impact. 15819.8;16092.9. <br /> BUILDING SIZE F SO FOOTAGE HEIGHT <br /> BUILDING $ 5,273.00 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL S AMP SERVICE OSTALLATION <br /> ERGY W.R.E.C. <br /> =PLUMBING $ - <br /> SENT VIA EMAIL <br /> =MECHANICAL $ VALUATION OF MECHANIC / <br /> V <br /> =GAS = ROOFING SPECIALTY = OTHER NOC <br /> FINISHED FLOOR ELEVATIONS $ FLOOD ZONE AREA =YES NO <br /> BUILDER /I w..eL!J./... �...,..w/, COMPANY Windom World of Tainpa 13ay,LLC <br /> SIGNATURE % % REGISTERED I YIN FEE CURRENT I YIN <br /> Address 10741 EndeavourWa)#C Seminole,F1.33777 License# SCC131151663 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURRENT YIN <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURRENT Y/N <br /> Address F License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURRENT YIN <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I YIN FEE CURRENT YIN— <br /> Address License# <br /> I I I I I I I I I I I I I I I I I t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <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/Sill Fence installed, <br /> Sanitary Facilities 8 1 dumpsler;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/Slit Fence Installed, <br /> Sanitary Facilities 8 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 8 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 /> Retools if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />