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<br />~\~~~ <br /> <br />City of Zephyrhllls Permit Application <br />Building Department <br /> <br /> <br />Date Rettaived · <br /> <br />Owner's Name <br /> <br />Owner's Address 5439 Beal.llOOIlt Cntr Bl <br />Fee Simple Titleholder Name I <br /> <br />Fax-813-780-0021 <br /> <br />OWner Ph~ne Number <br />OWner Phone Number I <br />133634 I <br />OWner Phone Number <br /> <br />Fee Simple Titleholder Add..... I <br /> <br />~B <br /> <br />I Silverado <br /> <br />0~~ I~ ~ LOT # 11~/3 <br />IU PARCEL ~ 4-26-24- CXlM-DI'J8f.l'rO.vto <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o SIGN D MOVE 0 <br /> <br />o <br />o <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />~ <br /> <br />E3 <br />D <br />~ <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br />Construct Single Family Residence <br />SQFOOTAGE I ~~Y10 <br /> <br />10:>~'-{Q I <br />1$ 1 (P / 31 '3 <br />1$ 6161 <br />1$ SC; &~ <br />1$ 't3/b <br />o <br />FINISHED FLOOR ELEVATIONS r:; tfII') <br />UUl.{QD <br /> <br />BUILDING SIZE <br /> <br />- <br /> <br />D <br /> <br />BUILDING <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL 0 <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />,U~I!~~ <br /> <br />D <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />'NRE.C <br /> <br />D <br /> <br />PLUMBING <br /> <br />cz( <br /> <br />o <br />No~ ~cP <br />~p~ (k'6 <br /> <br />D <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />D <br />I <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />D <br /> <br />GAS <br /> <br />ROOFING <br /> <br />OTHER <br />DYES <br /> <br />I'::/INO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY ~ard Hanes ~ <br />REGISTERED ~ N I FEE CURRENT ltpN I <br /> <br />License # I CBC1 252865 <br /> <br />Attach (2) Plot Plans; (2) sells of Building Plans; (1) aet of Energy Forms <br />Minimum ten (10) working daya after submlttlll date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster <br />Attach (3) .... of Building Plana; (1) .et of Energy Form.. <br />Minimum ten (10) working days after submlttlll date. Required onslte. Constructton Plans, Sanitary Faclllttes & 1 dumpster <br />All commercla' requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />.."PROPERTY SURVEY required for all NEW construction. <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />105 Douglas Rd OldsroarFL 34677 <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGI8TERED <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />l.lcense # <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />_I!~-- <br /> <br />!ilTIl~ <br /> <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of appllcatton, notarized <br />If over $2500, a Notice of Commencement Is required. (AlC upgrade. over $5000) <br />Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMmlNG (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />