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16-16617
Zephyrhills
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2016
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16-16617
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Last modified
2/16/2017 1:48:31 PM
Creation date
2/16/2017 1:48:30 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
16-16617
Building Department - Name
BACK,WILLIAM & DINA
Address
5121 19TH ST
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813-780-0p20 City of Zephyrfiills Permit Application Fax 813-780-0021 <br /> Building bepartment - <br /> Date Received �.2�,.- ''�,10 J� Phone.Contact for Permittin �� ✓��� - I� -� <br /> Owner's Name wf� �� L�8R� Ownar Phone Number �J��•�ss�f/� <br /> Owner's Address 3q�✓�� ��''��L""' ���� ���'`r Owner Phone Number G�r� �?��`3`�96 <br /> Fee Slmple Tltleholder.Name �6¢• � Owner Phone Number � � <br /> Fee Simple Titleholder Address ��f"• <br /> JOS AdORESS J�12.l J9� �T+�� ,z�P�Yr�ilLs��L.- 33�y2- LOT# � Y'CJ <br /> suaaiv�sioH C�7Y v�Z-al1'�G.S PB.� P �S�'pa�c���o# //'?-��1—DD/O—ZO/Ol —0060 <br /> (OBTAINED FROM PROPERTY 7AX NQSICE) <br /> WORK PROPOSED , e NEW CONSTR ADD T SIGN [�] Q QEMOLISH <br /> INSTALL PAIR <br /> PRdP03ED USE SFR Q COMM � 07HER <br /> TYPE OF CONSTRUCTION BLOCK � Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK �pQlrl �"Sad/J7'D�(,fcS .Z IrIlQ�.I�!� ����D1'� �rS?T3/�,�0� 11�tl �Q�T?I���I <br /> �� i��oRr%f}�'-S �"-f?1�? <br /> BUILDING SlZE Z� /.�'��c�STDR1�fo� SQ FOC}TAGE �2� HEIGHT �� '—�/ <br /> BUILDING $�8'�r��=b�., VA�UATI4N OF TC1TA1.CC?NSTRUCTI <br /> _� <br /> �ELECTRICAL $�i C�� � OC? AMP SERVICE �OZ� PROGRESS ENERGY W.R.E.C. <br /> ,�X/S�"Ti�lG <br /> �LUMBING $ � �� � Gp �j <br /> I .�� 1 <br /> �MECNANICAL $�f���� pt� VALUATION OF MECHANICAL INSTALLATION �G�� � � <br /> C��S� � ��1 <br /> ROOFING Q SPECIAITY [� OTHER �,,� <br /> FINISHED FLOOR ELEVATIONS ��s FLOOD ZONE AREA [�YES NQ � t �� <br /> t1tiJ Nf�tJ�✓ _ � <br /> BUILDER � w"� caMPw+rr /�4�1�'c��/�✓�-- <br /> StGNATURE REGISTHRED Y/ N FEE GURRE� Y/N <br /> Address .����8 � �A�� Gl/�C'eY� Z�7LGS' License# �—� .��.�,.�.� <br /> �LECTRICIAN � /�,�„ ��� COMPANY !?�'QJ����� <br /> SIGNA7URE Kf � REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres� �'h�'/�'?E- �� p�D�P�E"'' l#cense# ��^"—""'"j(l.fi'�� ( i <br /> i <br /> PLUMBER � � ����, COMPANY �1�D�d� <br /> SiGNATUR� REGISTERED Y! N FEE CURRE� Y/N <br /> Address c��E �`� �D��" License# f /t/.�� � <br /> StGNATURE 1����ii��'"�� ROMPANY 1�n1�fJ�,P�'�uwzEn Y/N <br /> Address rS�t'% Ff'�J�yci License# � ��'- �� <br /> OTHER �kI/fI� COMPANY ��I�l1L�i�i�:� <br /> StGNATtJRE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addres� +�i �}"'s ���- License# �` r�'!! f t . ��� <br /> RESIDENTIAL Attaah(2)Riot Pians,�(2)se#s of Bulidl'ng'Pians;(1)set of Energy Fortns;R-O-W Perinit for new co�struction, <br /> M[nlmum.ten{10}wrarlcing:cfays.atter submtttat date. Required onsite,Constructian Plans;Stormwater Ptans w!Siit Fence installed, <br /> Sanitary FacillBes&.1.dumpster Site Work;Permit for subdiv�stonsllarge projeats <br /> COMMERCIAL Attach(3).complete sets of Buiiding Plans plus a Life.Safety Page;(1)set af Energy Farms.R•O-W Permit for new canstructio�. - -- <br /> Minimum ten(10)working days after submtttal date. Required onsite,ConstrucUon Plans,Stormwater Pians wl Silt Fence Instatled, <br /> 5anikary FaciliUss&7 dumpster.Site Wark Permit for ai!new proJects.Aii commerciai requirements must meat campllance <br /> SIGN PERMIT Attach(2)sets of Eng(neer,ed•Flans. <br /> *"'PROPERTY SURVEY required for ail NEW constn.�ction. <br /> Directions: <br /> Fill out appticaUon completety. <br /> Oumer&Contractor siga back of applfcatlon,notarfzed <br /> If over�2500,a Notice of Commencement[s required. (AIC upgrades over�T500} <br /> "" Agent(for the contractor)or Power of Attomey(for fhe owner)would be someone with notarized lettec from owner authorizing same <br /> �VER THE COUNTER PERMITTING (Front af ApplicaBon Only) <br /> Reraafs if shingles Sewers Service Upgrades AIC Fences(Plat/Survey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />
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