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12-13165
Zephyrhills
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Building Department
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Permits
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2012
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12-13165
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Last modified
4/16/2013 8:44:42 AM
Creation date
4/16/2013 8:44:41 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
12-13165
Building Department - Name
SAMI,SAMUEL & SACHER-BROWN TOM
Address
5525 5523 23RD ST
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813-780-0020 City of Zephyrhills Permit Application <br /> Fax-813-780-0021 <br /> Building Department <br /> Date Received � Phone Contact for Permitting - <br /> c �; ��J � � ��L�,� _ ��,,,,, O"`^Owner Phone Number O�� �t3��-�� �St�7J <br /> Owner's Name /�^ <br /> Owner's Address �� � 2 ( Owner Phone Number <br /> Fee Simple Titleholder Name <br /> � i� �� � 3��� Owner Phone Number <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS <br /> S5a5 �>'� (7�• � LOT# <br /> SUBDIVISION PARCEL ID# I�`'�6-2�' ����'� �vS� �d�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> SFR � COMM Q OTHER <br /> PROPOSED USE � STEEL Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME 0 <br /> DESCRIPTION OF WORK <br /> ��+�v� .�.,L� -aa.�r c �e l �✓�S � �'�-`�C�� <br /> BUILDiNG SIZE SQ FOOTAGE HEIGHT <br /> � BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL $ �� � � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> � PLUMBING $ ���("' � ���,,�" " ' �� <br /> VALUATION OF MECHANICAL INSTALLATION �� ���(ST <br /> � MECHANICAL � s S <br /> 0 GAS Q ROOFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES ONO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRENT Y/N <br /> Address License# <br /> ELECTRICIAN _��Y��_ COMPANY 'e- Uu � �`n C <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address � �1�c�`� b 2- Z-'V�, 3 S License# �C��j(���3 S� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y!N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT 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&1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)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 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 /> i�r������1111111�7 <br /> --- L1L11 L I J iJ1L 1 <br /> Directions: <br /> Fili out application completely <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$500U) <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 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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