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14-15093
Zephyrhills
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Building Department
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Permits
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2014
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14-15093
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Last modified
3/16/2015 11:37:32 AM
Creation date
3/16/2015 11:37:32 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
14-15093
Building Department - Name
WUJTOWICS,JAN & HENRIETTA
Address
5636 19TH ST
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813-780-fJ020 City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin __ <br /> Owner's Name `�-� W � �--� � � �' Z Owner Phone Number �'�3 7�� ��f' <br /> Owner's Address ��J� � � 5� Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# �� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) ' <br /> WORK PROPOSED � NEW CONSTR 8 ADD/ALT � SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK (J�Z( � �.. <br /> BUILDING SIZE SQ FOOTAGE �Z�9 HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> �-��v�� <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> 3l'p �-v <br /> QGAS Q ROOFING Q SPECIALTY � OTHER ���/�! <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 1 N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address License# <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL � � � COMPANY / /� �GO` <br /> SIGNATURE REGISTERED / N FEE CURRE� 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 ot 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 instatled, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivislons/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 instalted, <br /> Sanitary Facilities 8 1 dumpster.Site Worlc 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 consVuctlon. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> "" Agent(for the conVactor)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 shingtes Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />
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