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08-7587
Zephyrhills
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Building Department
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2008
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08-7587
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Last modified
3/6/2009 4:46:48 PM
Creation date
5/13/2008 9:53:26 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
08-7587
Building Department - Name
WUJTOWICZ,JAN
Address
5636 19TH ST
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<br />813-780-0020 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />/9 T H S ;:- ;2--..t=- P /r}1 ~ If { 4t..:s <br /> <br />I PARCEL 10#1 <br /> <br />[:=J ADD/ALT 0 <br />[2:1 REPAIR <br />CJ COMM 0 <br />CJ FRAME 0 <br />/ M / ,-.-. <br />--t:L 6' .: 0 /l/ L-- <br /> <br />BUILDING SIZE sa FOOTAGE I I HEIGHT <br /> <br />,'..",..."",.""...,.........................................................,.........,....................................,............."" <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />..:!>~3C. <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />3>/: 7: <br /> <br />D BUILDING 1$ I <br />D ELECTRICAL 1$ I <br /> <br />c::;eJ PLUMBING 1$ ~~l) ~t;) I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS 0 ROOFING CJ SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br /> <br />..'..1..1,.1.,11.1',......,.1,11.11,.'.,1.,.'.,.1..1.,""1"";"1""'1"""1""1"""""'1""""'"'1.1'.'...'1..'.11..'.1.11'.1..1...... <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />CJ <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />\~~~. <br /> <br />fv~;{1~ F~~~ ~ ~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />YI 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 />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y IN I. <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />III1IIIII1II111111111111111111111111111111111111111111III1IIII1III1111111111111111111111111111111111111111111II1IIIIIIII11111111111111111111111111 <br /> <br />Address <br /> <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 for subdivisions/large projects <br />COMMERCIAL Attach (3) 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 />I111I111IIII1111I11111111111II1111II1111I1111111111111I1111I11111II1111I11111111111111111111111111111111111111111111111111111111111111111111111111 <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 cqntractor) 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 /> <br />("..... <br /> <br />< <br />
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