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I � <br /> � s�aaso-aozo City of Zephyrhills ermit Application Fax-813-7$d-0021 <br /> . Building D artment <br /> Date Received Phone Contact for Pe� itt[l I 813 7 8 2 __ 9 0 8 0 <br /> ttlillii <br /> Owner's Name Rubin, Harvey N & �7udith J Owner Phone Number ._., <br /> Owner'sAddress 6642 Northlake Dr. Zephyrhills, FL 335420wnerPhoneNumber � � <br /> Fee Simple Titleholder Name Fee Simple Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JdBADDRESS 66�2 Northlake Dr. Zephyrhills, L 33542 ��T# 24 <br /> SUSDtVtSiON Silver Oaks � PARCE�tD# 03-26-�1°0�50�t}OQOb-(?200 <br /> (48TAINEp pqAM NROPER'YY TAIt NO'RCEy <br /> WCtR!(PROPOSED e NSTA��STR� A��b/�A�� � SIC3N � �J DEMOLISH <br /> PROPOSED USE Q SFR � COMM � OTHER <br /> TYPE OF C4NSTRUCTION Q BLOCK � F'RAlNE �,� STEEL Q <br /> DESCRIP7'ION OF WOF2K T�� �FF EXZSTIIVG 12C7fJ�' �YS�' M AND FtEPLACE WITH TIMB���,,It�TE k�D T20C1F <br /> BUILDING SIZE �— � SQ FOOI'AC+E ��g 4 HEIGHT �_� <br /> QBUILDINC�ROOFIN 12 r�0�.p Q VALUATION CJF O"�AL CONSTRUGTION <br /> QELECTRICAL �� AMP 5ERVICE � PROGRESS ENERGY � W.R.E.0 <br /> OPLUMBING �� � ��/� <br /> ,"C <br /> OMECHANICAL �;6� VALUATION qF ECHANiCAL INSTALLATION <br /> L <br /> QGAS Q ROOFING Q SPECIA�.1"Y � OTHER <br /> FINISf-IED Ft40R ELEVATIONS E� � FLOOQ ZO E AREA QYES NO <br /> BUILDER `_ / _ ..� COMP Y ��SdN NEtTMANNjI��UMANN ROdFING <br /> SIGNATURE �IV ��-`� REGISTE ED Y/ N FEE CURREN Y/N <br /> Address 30427 COMMERCE DR, SAN ANTONIO, FL 576 License# �CC7326266 � <br /> ELECTRiCIAN � � COMP Y <br /> SIGNATURE REGISTE ED Y/ N FEe CUFtR�N Y/N <br /> Address License� � i <br /> PI.UMBER � CQMP Y <br /> SIGNATURE I REGISTE ED Y/ N FEE CURREN Y/N <br /> Address License# �` �� <br /> MEGHANICAL G{}MP Y <br /> SIGNATURE REGISTE ED Y/ N FEE CURREN Y/N <br /> Acidrsss License# �— � <br /> OTHER � COMP Y <br /> SIGNATURE REGIST REp Y 1 N FEE CURREN Y 1 N <br /> ,qdd��$ License# �—y � <br /> IIIIIIIIIIIIIIIIIIIIIIfillltiittl11111tttilit � Il / 111iiIlIilllilliif <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets ai Building Plans;(1)set of E ergy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10}working days after subrrsi#a1 date. Requi ansite,Construciion Plans,Starmwater Pians wl Silt Fence insfaited, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdi isions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safe Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten{14}workir:g days after submittal date. Requi d onsite,Constructian Pians,Stormwater Plans w!Siit Fsnce insta0ed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all n projects.All commercial requirements mus#meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •*'"'PROPERTY SURVEY required for aII NEW constructia . <br /> Dlrections: <br /> FiII out application campletely <br /> Owner&Contractor sign back of application,notarized <br /> If over S25Qp,a Notice of Commencement is required. (AIC upgrade over S750p) <br /> " Agent(tor the cantractor}or Power of Attomey{far the owner}would be s meane wifh notarized ietter from awner autharizir�g same <br /> OVER THE COUNTER PERMIT7ING (Front of Application Only) <br /> Reraafs if shingies Sewers Service Upgrades A!C Fences{PI tlSurveytFootage} <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />