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�,s-.�u-u�-zo � Gity of Zep�tyrhills Permit Application �aX 8�a-�saaa2� :
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<br /> Building Department . ;
<br /> Date Regelved , �- . � . phone>Contact forP�armittln $–c� Z` � � �"
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<br /> Owaer'a Name { 7�. �Gf,_�+ Owner Phone Number ,�`� ,�a % `
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<br /> Owne�s Address G s �/ � Qwner Phone Number �� � �
<br /> Fee Simpte Titleholder Name � � •i�wner.Phone IVumber �� �
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<br /> Fee Slmpte Titteholder Add�s
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<br /> J08 ADDRESS � '�,0 + Lt}T# C____��� �
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<br /> SUBDIVISION �:.Li.�,�_��' PAltCEL,Id# �- - �� � -Z—��-----t;, �C:�Qe� f,� ;
<br /> � (OBTAINED EROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSELI �NEW-COtdnR ADD/ALT [� SIC3N Q• [� DEMOLtSN j
<br /> -�. INSTALL 8 � � REPi0.1R
<br /> PROPOSED:USE Q SFR� Q COMM• OTMER � 1f',� G- � �
<br /> TYPE OF C�N8TRUCTtOW Q� � BIOCK " Q FRAME � S'C�EL Q �
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<br /> DESCRIP110N OP WORK � /�l l � I` �i`L-r f--
<br /> BUILDING'SlZE � � SQFOOTAGEC�; , .N GHT�:� � !
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<br /> QBUILDING �� VAl.tlATION�F TOTAl."COiVSTRUCTiON' � {
<br /> C]ELECTRICAL �� AMP SERVICE � PROGRESS ENERGY CJ W.R.E.C.
<br /> QPLUMBING $ ' ' i
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<br /> MECHANICAL $ / /' VALOATION OF MECHANICAL INSTALLATION f
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<br /> QGAS Q ROOFING .Q SPECIALTY � OTHER•
<br /> FINtSHED FIOOR ELEVATIONS ��� � F�OC}D zONE AREA QYES. f�t0
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<br /> 9UILDER COMPAMY` .
<br /> SiGNATtIRE t���§t�o- Y i �1 . �E ct���n Y 1 N i
<br /> Address ' � ' Ltcense#'� � ;
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<br /> ELECTRICIAN. `�GOMPANY � � �
<br /> St�NATtlRE � �tE�EST�a�o Y I N ��cuR�ER�' ' '-Y 1 N i
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<br /> Address - , , Llcease# r � �
<br /> PLUMBER ' COMP:,A[!IY . ,
<br /> StGt+tATiiRE' ` _ _rt���ii�o,. Yl>N.. , F�E cu�E�+ Y l N �
<br /> Addrass L[cense.# I�. • � ,�
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<br /> MECHANICAI: ' .� COMPANY, �. •,
<br /> SlGNATURE '` 1'tE�f,15TEE2ED N FEE CC1RREtz. Y-/ �
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<br /> Address' '�OZ�,.7 ' v.' �-�f � , Ucsns.e# ,, _ (
<br /> dTHER - ' : . ;COMPANY , II
<br /> SK3NA'EURE '3,: `� � `-'`: :: ` ` ' ' ' FtEGlSTERED Y/ N,_; _FEE GURREt� Y I N 1
<br /> Addres� . . ~ _ ' . ' �, - � - License# � � � �� `
<br /> RESIDENTIAI;;;�' Attachi"'(�)„PIot�Plans,.:(2•)"sek"s":ofiBuilding?Pla"ns;;:(1)setof�Ene`rgY�;Farinsz�R=Q=1NYPefinitf6�newaonshucUon, "
<br /> ;_�,�:Mlofmum�ten��{�1A)wworiting,day,s;after";`>'subfilEkal'date:;�:ReRutreid onsite;sCo`n�trucflon�.Plans;=�3tormwater Plaris�w!Slik'Fence instafled,
<br /> � Sanitary FadIS#ies.&s�ly,dumpster,_..Site�Work�Perrnitfinr�sutidivisiongilaige�pro)ects;.4-,,",':; • � ` ��
<br /> CQMMERCIAI. Attach(3j`ccm�pl`efe'sefs�'of'9uililfng'Plans�plus a CIfe�Safety Page;�(1)set of Energy Forms.R-O-W Pennit for nev�canstruction.
<br /> Ml�imum ten(10�warfcing dayr�after submlttai dafe. Reqaired ons3#e,Canstructian Ptans,8tarmwa#er PEans wl Sitt Fence instalied, ,
<br /> Sanitary Fadiities&1 dumpster.Sitsr Work PertniF fiar al�new:prcjeats.Ali commerr.#ai[equlr�menis;must meat compilance �
<br /> SIGN PERMIT Attach'(2)"'sets ofE�g�nee.r:ed�Plans:�,.._• .-- , , •'. , , ,
<br /> ,•*,PROFERI7 SURVEY requlred ior a111UEW construc�on..
<br /> Directlons: •- � � ,
<br /> FtN out appitcaticn comptetely.
<br /> Ownar 8 Contractor slgn back of appl(catlon,notadzed �
<br /> If over�2500�a Notice.of Commencement i�requlred. (AIC upgrade�over 57500)
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<br /> "' A�qent(far the contsaCtar)Gt"Powe"r:of�Attotney(for the owner}would be someane wlth natarized le#ter ftam awner authodzing same
<br /> OVER THE COUN7ER:PERMITTING– -- •(Front of•Applicatlan•Only)-- �
<br /> Reroafs t#shingtes Sawers Servtce Upgrades NC Fences(PtaUSurveylFootage}
<br /> Drivewaya-Not over Counter if on public roadwrays:.needs ROW
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