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10-11249
Zephyrhills
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2010
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10-11249
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Last modified
10/13/2011 2:47:21 PM
Creation date
10/13/2011 2:47:19 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
1249
Building Department - Name
POTWIN,ANTHONY W
Address
5453 12TH ST
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813- 780 -0020 City of Zephyrhills Permit Application Fax- 813- 780 -0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin <br /> Owner's Name ' � v - <br /> /? �pi ! /� Gv Owner Ph a Number. r / <br /> Owner's Address Owner Phone Number I 5'/.-e— 7 7 k <br /> Fee Simple Titleholder Name . I./172 J G j �i> / 7 J jai - j) Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS / q 5 3 5t } <br /> L LOT # <br /> 1 <br /> SUBDIVISION PARCEL ID# — 2 7 _ / — O J / C3 / _- Jb 5 v <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN pi [V DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE I SFR n COMM I I OTHER I <br /> TYPE OF CONSTRUCTION fiSn BLOCK rszi FRAME L STEEL I] 1 <br /> DESCRIPTION OF WORK = . J 07,i)e. , <br /> BUILDING SIZE SQ FOOTAGE ) (J C/ HEIGHT I <br /> 14BUILDING $:. VALUATION OF TOTAL CONSTRUCTION <br /> I1ELECTRICAL $ AMP SERVICE I I PROGRESS ENERGY I W.R.E.C. <br /> I IPLUMBING <br /> 1 (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION .mil J / <br /> I IGAS h ROOFING [1 SPECIALTY I 1 OTHER / <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I YES <br /> BUILDER : _ <br /> COMPANY Gam.' L� <br /> SIGNATURE 4:-. i. '"Z ` �i C �� -t REGISTERED 1 Y / N I FEE C tREI I ¥/N I <br /> Address License # 1 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREI I Y/ N I <br /> Address I License # I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREI I Y/ N I <br /> Address License # I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N J FEE CURREN 1 Y/ N I <br /> Address I License # I <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREI I Y/ N I <br /> Address License # I <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 /> 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 (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />
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