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si3aso-oozo� City of Zepliy�hills.Permit Application Fax-813-780-0021
<br /> � Bullding Deperlmenl
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<br /> D'ale tiecalved . . , _,_„ .phone ConlAol tor PemilNin
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<br /> i Owner's Name. . . � . .: ... .. ..... Oivner Phooe Numder . . .
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<br /> ' OWner'A Addrese � S� . .—...��,. � . . ne'r Phone NumbAr
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<br /> Fee 81mple Tllleholdar Neme _..._..:, . ,,...._�.....•.. .. , . . .. . bwner pFione Numb6r �....-.,.__ , : .
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<br /> Fee 9lmple Tllleholder Addrese . , .,.,. ....
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<br /> JOB ApDRE88 � . ' �l ._ .
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<br /> SUBDIVISION .. . � ... _.._ . . . . PARCEL IUp I ��(J:�I.-G�I_^l /CYI� O-._.......... . ..
<br /> �� (OBTAINED FROM PROpERTY TAl(IIOTICE) '
<br /> WORK pROPOSED NEW coN§TR ADDIALT -_L.'� SIGN [� Q DEMOLISH
<br /> e IN8IALL 8 REpAIR
<br /> PROPOSED USE
<br /> Q SFR [� COMM � . .. _. .. ... ,. _ .
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<br /> TYPE OF CONBTRUCTION • Q 6LOCIC Q FRAME � STEEL Q r,,—� ',—�
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<br /> DESCqIPTION OF WORK ... . _ �. Gtn Q(J�.�'.. . . -
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<br /> 9UILOINO SIZ� ._. .. _ .,.__ ....... .. SQ FOOTAGE _,.�_�. HEIOH7 ��
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<br /> QBUILDIN(3 $ VALUATION OF TO7AL CONSTRUGTION
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<br /> ELECTRICAL $ ' ' ' AMF'SERVICE �.�. PROGRESS ENERGY � W.R.E.C.
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<br /> r�PLUMBING $'" �
<br /> �MECHANICAL $� VALUATION OF MECHANICAL INSTALLATION �
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<br />, L�DAs � �tOOFIN� Q SPECIALTY � OTHER \
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<br /> FINI9HED FLOOR EL�VATIONS FLOOU ZONE AREA QYES NO
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<br /> BUILDER COMPANY .
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<br /> 910NATURE • --,
<br /> .. . . ....... .. . ._.... . .... REOISTERED .Y./.N..� FEECURREA. � �_YLN_.
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<br /> Addrese ;'
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<br /> � ELECTI2ICIAN �GOMPANY
<br /> 316NATUFiE ... ... ........... .
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<br /> I - � �� � � . REOISTER�D ' .Y/�N . FEE CURREA� Y 1 N. '
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<br /> � Addresa . . . .. Llcense#
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<br /> pLUMBER COMPANY , —�
<br /> SIONATUfZE _ _ REGISTERED Y I N.: FEE CURRE� � .Y I N-. �
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<br /> Address .... .. .. . ... .. .. . ._. . .. , ,.. lJcen'se# .
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<br /> MEGHANIGAL , . COMPANY \r��. ��(� ��.../�(�
<br /> SII3NATURE � , .... . .. .....'. . ,., REOISTERED _Y.L N._. FEE CURREI. ,.Y.I N..
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<br /> Addre9s ��0 _ . . .. W...�. _ ..�3:3,� , Ll6ense# �Jd.���9��
<br /> OTHER COMBANY .i
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<br /> 51(3NATURE . rieois7EaEo Y f N�. �EE CUakEn' Y./N ' '
<br /> Address . . . . . ... . .. . ... . . . .. License# .
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<br /> RE8IDENTIAL AllAch(2)Plol Plane;(2)sels'ot Building Plah�;(1)sel p(Energy Forms;R-O-W Permll lor ne+k conslrucllon,
<br /> Mlnlmum len(10)working days'9fter su6mltlel dale. Requlred onslle,Consliuollon Plans,"Slortnwaler Plans w!SIII Fence Installed,
<br /> Senllery Fecllllles&1 dumpsler;Slle YJarli Permll tor subdlvl'sionsllarge proJecls
<br /> i COMMERCIAL Atlech(2)complete sels ol Bullding Plens plus.e LIf9 Sefety Page;(1)ae�of Energy Forms.R•O-W Permlt tor new consWcllon.
<br /> Mlnlmum len(70)working days efler submlllal dale. Reyulred onslle,Construcllori Flaris,Slortnweter Plens w/Slll Fence Inslalled,
<br /> Sanllery.Fecllllles&1 d'umpsler Slle Wbrk PeFmll(orall new praJe6ls.All commerclal requlreinenls rriusl meel compllance
<br /> i SIGN PERMIT Allech(2)sels o(Englneered Plens: ,
<br /> ""PROPERTY SURVEY requlred for ell N�W constiucllon. , ,
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<br /> �i-'•-y '�:-+-N-1+ �-r,.�,��. .�.-.-`.':-�•..G-:-�F�-'. `�' '.=:-''�
<br /> • � Dlrectlohe:
<br /> FIII aul eppllcallon complelely.
<br /> Owner 8 Coniraclor slgn tieck 6(eppllcallon,noleriied
<br /> II over EZB00;a Nollca of.Commencemenl Ie rAqulred. (A/C upgredes ovaP 57600)
<br /> " Agenl(tor lhe conliealar)oc Power ot Allarney((ar the owner)would be someane wflh nolerized leller(rom owner eulhorizing seme
<br /> OVER THE COUNTER P�RMITTINO (copy af coqliecl reqWred) �
<br />� � Reroofs It shingles Sewers Se'rvlce Upgredes AIC Fences(PIoVSu�veylF6otege) _
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<br /> , Drlveways-Not over Counler If on publlc roadways„need9•ROW�+• =����•-• `� , , , _ � .
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