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10-10013
Zephyrhills
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2010
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10-10013
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Last modified
1/26/2011 8:32:50 AM
Creation date
1/26/2011 8:32:49 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-10013
Building Department - Name
DAHLBACK,DANIEL & GELONEK,BRITT
Address
4755 19TH ST
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813 - 780 -0020 City of Zephyrhills Permit Application rax -t Ii- eau -uuz i <br /> Building Department <br /> Date Received P • ne Contact f , r Permitting <br /> Owner's Name `. • C - W W / Owner Phone Number <br /> Owner's Address L T 7_3 --(7 ` Owner Phone Number <br /> Fee Simple Titleholder Nang,_. • 1 _44.0.... H i • ^ er • one Number <br /> _ , <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT # <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN I I MOVE I I DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE I SFR I I COMM I $ OTHER I <br /> TYPE OF CONSTRUCTION ( $ BLOCK FRAME 1 1 STEEL I I OTHER I I <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE S OOTAGE HEIGHT <br /> ■ ■■ <br /> I I BUILDING 11,, $ -� 7,) VALUATION OF TOTAL CONSTRUCTION <br /> I I ELECTRIC L $ AMP SERVICE 1 1 PROGRESS ENERGY I I W.R.E.C. <br /> PLUMB' G $ <br /> I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I ( GAS I I ROOFING I I SPECIALTY I 1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 $YES I $NO <br /> -1 . _ _ — .T. _ _ - . _ WSJ _ . <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ N $ FEE CURRENT I Y/ N I <br /> • <br /> Address License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N <br /> Address L , ense # <br /> OTHER �I/ COMPANY <br /> AY <br /> SIGNATURE ' � �� ' / REGISTERED 1 Y / , FEE CURREN Y <br /> Address !1=1ir.. License # I <br /> 4 41 1 - N 1-1 t- 4- 4- 41- <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 /> lIIIIIIIlltlIlltIlll <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 $5000) <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 (Front of Application Only) <br /> Reroofs 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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