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si��aaoo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> ' Date Received <br /> , Phone Contact(or PermiW — <br /> �rrTT rr r r i�r <br /> Ownefs Name Florida Seniors Properties,Ina/Doug Klinowski pwner Phone Number <br /> Owners Address 829 Eastwood Dr.,GOlde►t,Co 8041 pwner vr�one Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addmss <br /> JOBADDRESS 6701 DairyRoad �or# � <br /> sue�iv�sioN � � PARCEL IDA 02-26-21-0010-03900-0060 <br /> �aenu�Fno�t raoveatr rnx Nonce� <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT Q SIGN Q � DEMOLtSH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK Re-Roof <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY 7►�� � <br /> SIGNATURE "� REGISTERED Y/ N �cu n Y/N <br /> ,e,dd,� 30 reto Drive,Port Richey,FL 34668 �;�„�# CCC 1328842 <br /> � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE RE('a1S7ERED Y/ N FEE CURRE� Y/N <br /> Address License# �--� <br /> PLUMBER COMPANY <br /> SIGNATURE �cis�o Y! N �c�n Y!N <br /> Address V��# <br /> MECHANICAL COMPANY —� <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# �—� <br /> OTHER � COMPANY <br /> SIGNATURE �cis�� Y/ N F�cuar�n Y/N <br /> Address License* �� <br /> 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 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 1 1 1 1 1 1 1 1 I <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new constructlon, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Pertnit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of 8uilding Plans plus a L'rfe Safety Page;(1)set of Energy Fortns.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construdion Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster Site Work Pertnit for all new projects.All commercial 2quirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY iequired for all NEW constnrction. <br /> D�rections:• <br /> Fill out application completety <br /> Owner&ConUador sign back of applicatlon,noWrized <br /> If over i2500,a Notice of Commencement is required. (NC upgrades over j7500) <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 ff shingles Sewers Service Upgredes A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter ff on public roadways..needs ROW <br />