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19-21620
Zephyrhills
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Building Department
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2019
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19-21620
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Last modified
4/15/2020 12:39:20 PM
Creation date
4/15/2020 12:39:18 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
19-21620
Building Department - Name
POTWIN,ANTHONY & CHARLENE DALE
Address
5449 12TH ST
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> T17rrrrrT7717rrT1:T= ......... ... ....... ...... <br /> Owner's Name Owner Phone Number -3- <br /> Owner's Address 15q4q AP V rA/JA I owner Phone Number <br /> Owner Phone Number <br /> iqqJOB ADDRESS p4 LOT# <br /> SUBDIVISION PARCEL ID#1 11-Z1,ZI -COIL)— I?-seco- C)nB p-- <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR 8ADD/ALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE 0 SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK E:; FRAME 0 STEEL <br /> DESCRIPTION OF WORK <br /> V <br /> BUILDING SIZE SO FOOTAGE HEIGHT <br /> =BUILDING 1 VALUATION OF TOTAL CONSTRUCTION <br /> .A-n- <br /> FTqELECTRICAL AMP SERVICE DUKE ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS 1 FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY I <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LY_LN� <br /> e-,o- <br /> Address License# e-l (2 13A�2- X/0 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> MECHAP41CAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# F— <br /> RESIDENTIAL Attach(2j Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new 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 /> Pill, I'll 111"iiif Hiigliwil li 11 1 1 111"111111 <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 Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> I <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />
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