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12-13578
Zephyrhills
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Building Department
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Permits
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2012
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12-13578
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Last modified
7/22/2013 10:58:25 AM
Creation date
7/22/2013 10:58:25 AM
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Building Department
Company Name
PARK HILL
Building Department - Doc Type
Permit
Permit #
12-13578
Building Department - Name
HAYNES,SELMA
Address
6024 16TH ST
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813-780-0020 City of Zephyrhills Permit Application �.�� Fax-813-780-0021 <br /> , Building Department � —/ 3 <br /> r � <br /> Date Received <br /> Phone Contact for Permittin <br /> Owner's Name „�--G ��� �� <br /> Owner Phone Number � <br /> Owner's Address �'� 16 �— <br /> Owner Phone Number <br /> Fee Simple Titleholder Name <br /> Ovmer Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �/ I� � S �� <br /> LOT# <br /> SUBDIVISION PARCEL ID# (QZ — , � _ <br /> D D — �a0 �- <br /> WORK PROPOSED B (OBT/UNED FROM PROPERTY TAX NOTICE) <br /> NEW CONS7R ADD/ALT �� SIGN [� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK �] FRAME �� STEEL � <br /> DESCRIPTION OF WORK CD IlC,� �y 2A ��tD2 � � �, 0 �,,Zi s,�dr✓�¢� <br /> � l � � � <br /> i <br /> BUILDING SIZE SQ FOOTAGE�� <br /> HEIGHT <br /> QBUILDING a ,� <br /> � VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL $ AMP SERVICE <br /> � �g� W.R.E.C. <br /> QPLUMBING a <br /> 0 ������ <br /> OMECHANICAL $ VALUATION OF MECHANICAL IN <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 <br /> 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 � j COMPANY G-y�/ },/ 01j,��' <br /> SIGNATURE �--�'—� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address !� 0� ,3 1i �- G/ License# c�(�o�6 <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 FaGlities 8 1 dumpster,Site Work Permit for subdivisfons/large projects <br /> COMMERCIAL Attach(3)wmplete sets of Bufiding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon. <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 a�l new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '""'PROPERTY SURVEY required for all NEW constructlon. <br /> ,�������„������������„�. <br /> Directlons "' " <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of application,notanzed <br /> If over 52500,a Notice of Commencement is requ(red. (A/C upgrades over:7500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would be someone wtth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI771�1� " (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers ' �ervice Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />
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