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11-12663
Zephyrhills
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Building Department
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2011
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11-12663
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Last modified
6/20/2012 2:43:12 PM
Creation date
6/20/2012 2:42:33 PM
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Building Department
Company Name
SLEEPY HOLLOW MH SUB DIV
Building Department - Doc Type
Permit
Permit #
11-12663
Building Department - Name
MALINOWSKI,JOHN 7 JACQUELINE
Address
38701 REMORA AVE
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��� City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> . Date Received /� -��- Phone Contact for Permittin � r _� <br /> r <br /> Owner's Name Owner Phone Number � � <br /> Owner's Address � C/ � —� <br /> 1"�a.. Owner Phone Number <br /> Fee Simple Titieholder Name ��p �,(� S i va� � r Owner Phone Number <br /> Fee Simple Titleholder Address <br /> /t�t�s �c Db - <br /> JOB ADDRESS D l� (� � LOT # �� <br /> SUBDIVISION ,� �� K! PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM � OTHER / <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME [� STEEL Q <br /> DESCRIPTION OF WORK ��.° dC f � V� U/V.�PI� �N <br /> BUILDING SI2E /� n�� � SQ FOOTAGE � HEIGHT � <br /> UILDING $ �' � VALUATION OF TOTAL CONSTRUCTION <br /> / ODr� - <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> -�� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �GAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> . � ---� _. <br /> �/'BUILDER ; � I OMPANY <br /> ` ,SIGNATURE ' R Y! N FEE CURRE� Y/ N <br /> `. ��__--- -�' . <br /> Address ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <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 8� 1 dumpster; Site Work Permit for subdivisionsllarge 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 /> '" SURVEY required for all NEW construction. <br /> Dtrections: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is requlred. (A!C upgrades over s7500) <br /> " Agent (for the contractor) or Power of Attomey (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 (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs OW�� � R � ��p� '/ �� /lIJ � <br /> � � /`' !7/ " ! <br /> Orr (/��� ��•rLo <br />
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