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11-12297
Zephyrhills
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2011
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11-12297
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Last modified
5/14/2012 10:20:48 AM
Creation date
5/14/2012 10:20:45 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-12297
Building Department - Name
KREMPLEWSKI,MAE
Address
39232 8TH AVE
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��s-7so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Re�eived �� � phone Contact for Permitting -- <br /> y-rti <br /> Owner's Name /��/�'� Owner Phone Number O�✓ ���Z" J� <br /> Owner's Address ✓" 1�3� �. ' Owner Phone Number � � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Z � � LOT # � <br /> SUBDIVISION PARCEL � a���� r �3�Q" �`�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NSWA�ONSTR e REPAIR � SIGN 0 MOVE C] DEMOLISH <br /> PROPOSED USE � SFR 0 COMM d OTHER / 0 <br /> TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL O OTHER <br /> DESCRIPTION OF WORK �/�loYi Sl�l I/JCf � S�� � <br /> BUILD G SIZE C SGl FOOTAGE HEIGHT <br /> BUILDING $ ��� , � VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL $ � AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.0 <br /> � PLUMBING $ � � <br /> 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� <br /> � GAS 0 ROOFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES QNO <br /> BUILDE� ��S ' COMPAN � 11` r • U� �' <br /> SIGNATUR REGISTERED Y/ N FEE CURRENT Y/ N <br /> AddreO�s- 3 ��( 4�G • '�'Zi �j License # (i�J�i �2 S 2 Do <br /> O� <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address � License # � <br /> MECHANICAL � � COMPANY <br /> SIGNATURE REGtSTERED Y/ N FEE CURRENT Y/ N <br /> Address C License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # � <br /> RESID�NTIAL 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, Stormwaler Plans w! Silt Fence installed, <br /> Sanitary Facilities 8 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 8 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. (AIC 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 TNE 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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