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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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� eta-�eaoozo City of Zephyrhills Permit Application Fex-e��-�eaooz� <br /> , Bullding Departrnent <br /> ' DSte Recelved Pho�re Contect for Pertnittln 8 r 3 3$5 _ //95 <br />, ovm�rs Name �I�Lli4A'1 A. �f1C�C. Owner Phorre Nmnber cS�7E /9d V F <br />� ownersAddrean.3�I/OJ'r C�d/A/�IL s!✓E. �-IHc[s.F�33Sy OwnerPhoneNumber <br /> I Fee Slmple Tilleholder Neme Owner Phone Number <br /> i Fee 3lmple Titleholder Addrc�a <br /> I <br /> �os�oor�ss S/2/ /9� S'I: Z�Yk///GGS�P�� 33 S�� LOT i � <br /> SUBDMSION � PARCEL ID� <br /> (oerNrrto Faow r►eoreFmTroc Nonc� <br /> WORK PROPOSED B NEW CON57A e ADD/ALT SIGN Q Q DEMOLISH , <br /> INSTALL REPAIR <br /> PROp08ED USE Q SFR �] COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTtON OF WORK <br /> BUILDINO SIZE Sq FOOTAGE� HEIOHT r.� <br /> QBUILDING S VALUATION OF TOTAL CONSTRUCTIQN <br /> QELECTRICAL y AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a ' � :A�'t'(�(�}� <br /> I �T. . <br /> QMECHANICAL a VALUATION OF MECHANICAL INSTALLATION }��CO�F� � <br /> r <br /> I QGAS Q ROOFINO Q SPECIALTY Q OTHER <br /> FlNISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO <br /> BUILDER �� h /► � _ COMPANY ��P. ' �J9MFOW�E/t <br /> SIGNANRE «- ���� RECIs�aEo Y/ N �Ct�en Y!N <br /> Addrosa 39Jo-S �d�^��= �'E Z N'1G[S u�rrse# <br /> ELECTRICIAN � � �D COMPANY <br /> SIC�NATURE <U`�'�� ReGtslERen Y/ N FEE CURqEr, Y/N <br /> Addro� License# <br /> PLUMBER � � � COMPANY <br /> SIGNA7URE REGISTERED Y! N FEE CURREn Y!N <br /> Address ucense# <br /> MECHANICAL � � �� COMPANY <br /> S�GNATURE REG�sr�E� Y/ N FEE qltuEn Y!N <br /> Addroee Ucense# <br /> OTHER COMPANY � <br /> SI(iNATURE ` REG�s7ERED Y/ N FEE CURREn Y I N <br /> Address Llcense# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets ot Bullding Plans;(1)set of Errergy Fortns;R-O-W Partnit far new constructlon, <br /> Minlmum ten(10)worMng days atter submlltal data Required orelte,ConsWctlon Plans,Stormxater Plans w/SUt Fence irofalled, <br /> Senifary Fedlftlea 6 1 dumpster,31te Work PermN for subdlWslonsAarge proJecfs <br /> COMMERCIAL Altach(3)complete sets of B�rilding Plans plus a Liie SaFely Page;('I)set of Energy Fortns.R-O-W Permit for new construdlon. <br /> Minimum ten(10)xmrk(ng days after su6mittal date. Required onslte,Construcllon Plans,Stormxrater Pians w/Sift Fence installed, <br /> Sanilary Fadlitles 61 dianpster.Site Work Permit for all new proJecte.All wmmerdal requlrements must meet compliance <br /> 31GN PERMR Attadi(2)sets of Ergineered Plans. <br /> "•'PROPERTY SURVEY required for all NEW construcllon. <br /> Dlnctiona: <br /> Fiil out appHwtion oompletely. <br /> Owner 8 Contractor sign badc of appliptlon,notarized <br /> If over�.{'00,a Notice of Commencament Is requlred. (A1C upgredes over f'l600) <br /> " Agent((or the contractar)or Power af Attomey(for the owner)would be someane wfTh notarized letter from ovmer aufhorizing same <br /> OVER THE COUNTER PERMITTING (Frnnt of Applintlon Only) <br /> RefooTs H shingles Sewers Serviee Upgrades MC Fences(PbUSurvey/Footage) <br /> Drlvewaya�Jot over Counter K on publ'ic roadways..needs ROW <br />
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