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11-12555
Zephyrhills
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2011
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11-12555
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Last modified
6/19/2012 8:23:08 AM
Creation date
6/19/2012 8:23:06 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-12555
Building Department - Name
HALSEY,JEFFERY & DEANN
Address
5721 19TH ST
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s��-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> )ate Received � ' r, n � L <br /> Phone Contact for Permittin U <br /> Anrners Name Owner Phone Number �d .�`� <br /> �nrner's Address � ' t ��, t• Owner Phone Number —� <br /> 'ee Simple Titleholder Name —� Owner Phone Number <br /> 'ee Simple Titleholder Address <br /> !OB ADDRESS 1 �� � • I�1 � LOT # �� <br /> iUBDIVISION � PARCEL ID# � Z�Q -�� � �` •Q ° � U <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> JVORK PROPOSED NEW CoNSTR ADD/ALT [� SIGN Q Q DEMOLISH <br /> INSTALL B REPAIR '� � d2� <br /> PROPOSED USE �` SFR Q COMM � OTHER <br /> f'YPE OF CONSTRUCTION � BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK � �U I C� �L11 �� <br /> BUILDING SIZE SQ FOOTAGE ' HEIGHT <br /> Q BUILDING $ � --� VALUATION OF TOTAL CONSTRUCTION <br /> L <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> OMECHANICAL �� VALUATION OF MECHANICAL INSTALLATION <br /> QGAS �] ROOFING Q SPECIALTY [� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> ELECTRICIAN COMPANY <br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— <br /> �LUMBER COMPANY <br /> iIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Ucense # <br /> �AECHANICAL COMPANY <br /> >IGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— <br /> )THER ������ COMPANY � n� � <br /> iIGNATURE � REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address I��"ll License #��_ �� as S�j ^ <br /> ;ESIDENTIAL 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) wo�icing days after submittal date. Required onsite, ConstrucGon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilitles & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> :OMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construcdon. <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 commerciai requirements must meet compliance <br /> IGN PERMIT Attach (2) sets of Engineered Plans. <br /> '""PROPERTY SURVEY required for all NEW construction. <br /> ireciions: - • <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over s2500, a Notice of Commencement is required. (A/C upgrades over s7500) <br /> Agent (for the conVactor) or Power of Attomey (for the owner) would be someane with notarized letter from owner authorizing same <br /> VER THE COUNTER PERMITTING (Front of Application Oniy) <br /> eroofs if shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />
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