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06-5662
Zephyrhills
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2006
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06-5662
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Last modified
3/6/2009 4:20:36 PM
Creation date
5/29/2007 10:52:01 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
06-5662
Building Department - Name
TREE LN VILLIAGE
Address
5832 BROADMORE ST
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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br />~tL\l- \. ~oo(.o <br /> <br /> <br />Owner's Name T~~ l.:O> Yo!) -r. \"'E... l~r~ \\..1.A-~ <br /> <br /> <br />Owner'sAddress Ilo~\':L &~.t.,t ~\L-rQ(~U. R,~~~fll <br /> <br /> <br />Fee Simple Titleholder NamJ I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />OWner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />1 52?,d...- ~ffift.d f'c\("( 0 &-. Zp"~/h\ \\5 <br />tTra,.A1\(_ V\l\4~<- J PARCELlD#1 <br /> <br />B <br />o <br />o <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />Il~\ <br /> <br />lL "..... ~~ <br />I SQ FOOTAGE <br /> <br />fi\ rl<r 1-.-",,- j <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />..........11...111...11...11...11...1111...111111111.....11........11111..................11.11.................111.........11..1........11.111111 <br /> <br />fL, ~~-y '").- <br /> <br />LOT # <br /> <br />D <br />D <br />D <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />I <br />D <br /> <br />~r.I<- \~~ <br /> <br />HEIGHT I <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />\ 1.> ~eJ.0 <br /> <br />l~ P"'" I . <br />I <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />r$J ELECTRICAL 1$ I AMP SERVICE \\)0 U{] PROGRESS ENERGY <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br /> <br />.....111....11....11...111..111.........11...111............11....11.....111....1...11111............'1................111............'....1111111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />I <br />I <br />'-t~ ~ <br />5L.\\'\ ~ $t-- ~"'~l\b H- <br /> <br />'?;)~~ <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />111'11111111'11 1111111'11111111111"111111"'11"1'1111"11"'1111'"1111111"III"I"'II"IIIIII'IIII,IIIII'II,rll'IIIIIII111'111111111111111111 <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # I <br /> <br />I' ~~. Et e-L-m.Lc...J Ine-. <br />:!J N I FEE CURRENT lr ~ / N I <br /> <br />License # I I it1'1 <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />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 />IIIII~~&IIIIIIIIIII~IIIIIII~~IIIIIII~I&IIIIIIIIIIIIII~IIIIIIII~&IIIIIII~IIIIIIIII~IIIIIIIIIIII~&IIIIIII~~IIIIIII~~IIIIIIIIIIIIIIIIIIIIIII~IIIIIIII <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. (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />
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