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13-14106
Zephyrhills
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Building Department
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2013
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13-14106
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Last modified
3/24/2014 1:49:50 PM
Creation date
3/24/2014 1:49:50 PM
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Building Department
Company Name
SHAW LAKE RIDGE
Building Department - Doc Type
Permit
Permit #
13-14106
Building Department - Name
MERRILL JASON KERSHER & MADZY NIN
Address
37949 6TH AVE
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813-780-002Q City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � � � 3 Phone Contact tor Permittin -- <br /> Owner's Name .1 �SC�r'� ���.(-f", ( � Owner Phone Number O�i ' s � (T� <br /> Owner's Address 3 7`7�9 1 6 f� �I V e zP. � ,��1,���5 F�� ��Z p�er Phone Number o i3 v j�7''Q�/� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# � <br /> SUBDIVISION PARCEL iD# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT [� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER / ° L <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �✓ �e� '1r,{/ �+ D G E''� 0 <br /> BUILDING SIZE �— SQ FOOTAGE�� HEIGHT <br /> BUILDING 3 / ��� �.Ll� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ����� <br /> � <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO <br /> BUILDER ,/�'j�/����� COMPANY l ���l� d�W�1� <br /> SIGNATURE f�` � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# —� <br /> RESIDENTIAL Attach(2)Piot 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 Fadlities 8 1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)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/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster.Site Work Permit for all new pro)ects.All commercia�requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. • <br /> '"""PROPERTY SURVEY required for all NEW construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer 8 Contractor sign back of applipHon,notarized <br /> If over i2500,a Notice of Commencement is required. (A/C upgrades over s7500) <br /> "" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMiTTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />
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