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12-12676
Zephyrhills
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Building Department
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2012
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12-12676
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Last modified
1/25/2013 9:29:52 AM
Creation date
1/25/2013 9:24:13 AM
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Building Department
Company Name
ALPHA VILLAGE
Building Department - Doc Type
Permit
Permit #
12-12676
Building Department - Name
SIMPSON,TERRY & JOHANNA M
Address
38604 CAMDEN AVE
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s�3-�so-oo2o City of Zephyrhiils Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittln __ <br /> 'Owner's Name '�� h�n �� J v � -5�rn SCI'� ner Phone Nu�nber' <br /> �___.._..,,, , <br /> Owner's Address �86 b�l c�(l/>'��(GI1 f�V�° Owner Phone Number C <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � S b Lf �rn�� ��(, LOT# � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED F�PROPERTY TAX�nce)DEMOLISH <br /> WORK PROPOSED B NEW CONSTR ADD/ALT � SIGN [ <br /> INSTALL 8 REPAIR <br /> PROPOSED USE � SFR � COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �� STEEL � <br /> DESCRIPTION OF WORK J 1"� (���n �� �� �j �-e .�. ���`, � <br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT ] <br /> �BUILDING $ � <br /> 'QG � � VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY <br /> Q W.R.E.C. <br /> �PLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> CJGAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � ����` COMPANY f�i� � <br /> SIGNATURE � ��� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# � -� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# C <br /> RESIDENTlAL 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. Requi�ed onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit 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. (A!C upgrades over E7500) <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(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />
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