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srsaao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> - Building Department <br /> Date Received Phone Contact for Permitting — <br /> Owner's Name Craig Cornelison Owner Phone Number 813-788-7835 <br /> oW�ers aaa�ess 4445 Green Pond Road, Polk Clty FL 33 68 owner Pnone Number <br /> Fee Simple Titleholder Name Old 5th Investments, LLC Owner Phone Number <br /> Fee Simple Titleholder Address 4445 Green Pond Road, Polk Clty FL 33868 <br /> JOB ADDRESS 38039 Old 5th Avenue, Zephyrhills, FL 33542 � <br /> LOT# <br /> SUBDIVISION PARCEL ID# 11-26-21-0010-159-00-0060 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK Remove replace existing asphalt driveway and noncompliant ADA ramp <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> �BUILDING $ ���O VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ �� ��� „p�� <br /> (�- ���, <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ���a.�r��]/��,{J,� <br /> � r v"�4% <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> BUILDER ._ �F '� J� COMPANY <br /> SIGNATURE l(� � REGISTERED / N FEE CURRE� Y/N <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 /> . . . . . . . . . . . . . . . <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 Pertnit for subdivisions/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 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 /> *"'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) <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 ROW <br />