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21-1678
Zephyrhills
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2021
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21-1678
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Last modified
5/9/2022 12:15:12 PM
Creation date
5/9/2022 12:15:12 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
21-1678
Building Department - Name
MINE,JEFFREY
Address
5933 19TH ST
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813-780-0020 City of Zephyrhills Permit Application wD f /j),'Fax-813-780-0021 <br /> Building Department -�71V V <br /> a b� <br /> Date Received <br /> Phone Contact for Permitting — <br /> Owner's Name � � 14/l✓5 - Owner Phone Number <br /> Owner's Address _` 33 G Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresses (� <br /> JOB ADDRESS ? L�! S LOT# <br /> SUBDIVISION PARCEL ID# (r/r�l ©® © O P ` <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R <br /> NEW CONSTR 8 ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK QFRAME 0 STEEL �/Q <br /> DESCRIPTION OF WORK ®� G� Wi � ///��L�J <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> UILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . ._. <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LI.LN <br /> Address I License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE, REGISTERED Y/ N FEE CURREK Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREK Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N_J FEE CURREN Ly/N <br /> Address <br /> /�Lic'e/nse/ <br /> SIGNATURE # <br /> OTHER COMPANY �/ 1 �C.��`"�� <br /> //�� REGISTERED Y/ N FEE CURREN Y/N ,/ <br /> Address M I-A 1.76 3 Noe C-1-0 License# O e` �`� <br /> 111111111111111111111111111111 111111111111111111111111111111111111 <br /> RESIDENTIAL Attach_(2)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 forsubdivisions/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 w/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 /> . . . . . . . . . . <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 /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers :.:Service.Upgrade§_. Y ; Fences(Plot/Survey/Footage) <br /> Driveways-Not over,Counter if on public roadways..needs ROW'. <br />
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