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10-10602
Zephyrhills
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2010
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10-10602
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Last modified
2/3/2011 8:40:47 AM
Creation date
2/3/2011 8:40:46 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-10602
Building Department - Name
VANSELOW,ERNA
Address
5942 17TH ST
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813 - 780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021 <br /> Building Department <br /> Date Received l 4 Phone Contact for Permitting -- <br /> 111111111111111111 U1111111LLIILLLLLLtll 111111111 <br /> Owner's Name /U <br /> i /CC: /% jr vx ti S F t. e/'(). Owner Phone Number C 3 ; ?,f- <br /> Owner's Address 5% C. / 2 J 7 --e 5T Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> C if ✓ <br /> JOB ADDRESS S ` I v Z /1- 2— f j /'/Y/ /(4./.-a- LOT # <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I SIGN 1 I I I DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE I SFR I I COMM I' OTHER 1 I <br /> TYPE OF CONSTRUCTION I 1 BLOCK I I FRAME 1 1 STEEL 1 1 1 I <br /> DESCRIPTION OF WORK 5 ,.-'a'�' ("7/6164,3„c_, a, : 3 TU r 1 // "C 1 l7 li�-9 -0/ /3 CE ,"o �'- �G k.) <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> II IIIIttlllitittt <br /> 1 'BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> (ELECTRICAL $ AMP SERVICE I 1 PROGRESS ENERGY I 1 W.R.E.C. <br /> I 'PLUMBING $ <br /> MECHANICAL $ j Y"° ev_. VALUATION OF MECHANICAL INSTALLATION <br /> 1 (GAS I 1 ROOFING 1 I SPECIALTY 1 1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 'YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I <br /> Address License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURREN I Y/ N I <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED L Y/ N I FEE CURREN I Y/ N I <br /> Address License # <br /> S c. rL�dv • i j i; , � 2'Y f�C 45 /-+ `3-- <br /> MECHANICAL r .A . / COMPANY <br /> SIGNATURE J / � n �/'� 7 / REGISTERED I Y / N I FEE CURREN I Y / N I <br /> Address 7.4-r t ie- - l? t:-L'i fJ(:.:. °.i--ofWh, Fe.) License C c -r <br /> License # l � I` <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y / N I FEE CURREN I Y/ N 1 <br /> Address License # <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 /> tilt(till1111111111111 1111111111111111111111111111111 111111111( 11111111111111111111111111111111111111 <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is requ (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 (Front of Application Only) <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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