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813-780-0020 City of Zephyrhills P rmit Appiication S�zg Fax-813-780-0021 <br /> Building Dep rtment <br /> Date Received Phone Contact for Per itting 813 783 _ 1688 <br /> �rrrrm— � <br />� Lawrence& Patricia Kieper 813-469-1391 <br />' Owner's Name Owner Phone Number <br />'I Owners address 5013 19th Street, Zephyrhills, FL 33542 Owner Phone Number <br />� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS 38907 South Avenue LOT# 17,18,19,20 <br /> SUBDIVISION Np` PARCEL ID# 11-26-21-0010-21500-0170 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME STEEL � <br /> DESCRIPTION OF WORK COMPLETE DEMOLITION <br /> BUILDING SIZE SQ FOOTAGE 1600 HEIGHT 1 story <br /> rf—rm— <br /> OBUILDING $ �' O D VALUATION OF T TAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> �MECHANICAL $ VALUATION OF M CHANICAL INSTALLATION � ��j C � <br /> � <br /> �GAS � ROOFING Q SPECIALTY OTHER ���� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZON AREA DYES NO <br /> -�1--1-1--�HI--��1--FFI--1-1-1--1-�-N-1-f-���1--��1--�FI--1-FI--f--1- 1�-1-a-1--1-1-1--HHI-+-1-f�-��1--�FI--1-1-1--1--�-F-1-1-1--1- <br /> BUILDER COMPA Y CROSS ENVIRONMENTAL SERVICES, INC <br /> SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N <br /> Address E'•O. BOX 1299, CRYSTAL SPRINGS, FL �icense# CGC062981 <br /> ELECTRICIAN COMPA Y <br /> SIGNATURE REGISTER D Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPA Y <br /> SIGNATURE REGISTER o Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPA Y <br /> SIGNATURE REGISTE ED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMP Y <br /> SIGNATURE REGISTE ED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> Illlllllllllllllllllllllllllllllll�llllllllllllltltllllltlllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of En rgy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Requir d onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdiv sions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety age;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Requir d onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all ne 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 /> �..f�1..f�f�f..L��l..l..i�f��l�l..�l�l..i�1�1..��1-.��1..�1�1..��1..1.� 1..1..1.�1..1..�'..�..�G..��I..1..1.�• • • 1..��1..4. <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 Attomey(for the owner)would be so eone 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(Plo Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />