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<br />813-780-0020 <br /> <br />City of Zepnyrnllls t"'ell I Ill' I"\fJl.III,",CH'V" <br />Building Departmen,:t <br /> <br /> <br />i <br />! <br /> <br />Date Received <br /> <br />g - g-- Dl <br /> <br />Owner's Name rJ/Rf!TTOf/(GiI!. 2AtJ105 <br />Owner's Address ISbIJ I ~T" .s-r. <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />Kf' f ''--\ - <br /> <br />SUBDIVISION <br /> <br />ISbl1 /~~ <br />I <br /> <br />I <br />I (: (~Y'rl (1:'.... C,c\CJ.(- 1...)-'::' (~<::J <br />! t\(\~ \~ c\~Cl-^:- <br />II..<~ (-, L~ ~ (\ ~ )(:' ({,,~ '.(.u.~ ie', <br />I (\ +\c\c\\-~1J"aJ...:. 4 t"~:::::> ) <br />\,~ (~l_-,,-"C\ v~ c \) C'-- C' "c\- <br />" " .' , \,,,}' .' <br />C\1 _l\"U.-;, p~cn"'\.A.:_t <br />I '#- t..c,.'l3C! <br />I .., <br />I 'b~ \\ l\"~\(..o(c\ .-+-~~ <br />i)\ On-<) I. ~) C..? C -+\\(' <br />\-\ \/'1; 'S.:.:ciJUL <br /> <br />I LOT# I <br />I PARCELlD#I;o- ~~-21- oO(O-~' <ftJb - OO/D <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />New CON"" ~ ""',,'-' D SO"" D """" D <br />INSTALL ~.. REPAIR <br />PROPOSED USE D SFR COMM D OTHER <br />TYPE OF CONST~UCTION ~ BLOCK 0 FRAME D STEEL D <br /> <br />DESCRIPTION OF WORK I Fte€~".",A(.ie:D If?tE1StJ1l-D 'TR./-pc..E)C- <br /> <br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I <br />III................... ................... ... .....,.. II.. .. . .. ..,......:......................... .'..,................ 0.. .. <br /> <br />D BUILDING 1$ q <br />/O/OS>O.OO <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED <br /> <br />e <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />.... <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />) <br /> <br />~~y-- <br /> <br />ROOFING <br /> <br />o <br />I <br /> <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />VALUATION OF MECHANICAL INSTALLAT10N <br /> <br /> <br />BUILDER <br />SIGNATURE <br />Address ()Cf FOIl:'I14AJ6 K/;. ])1'ItJE <br /> <br />ELECTRICIAN I~t... I" <br />SIGNATURE~~\I.:::.v~ <br /> <br />Address I ~.cdSi){ 'l?b~ 2-,^~~~ ~L <br /> <br /> <br />~~~::r~E I~ ~ <br /> <br /> <br />Address I ~ Pi I q 4 c...R. 5 I.f C. <br /> <br /> <br />MECHANICAL I LP'. <br />SIGNATURE . ~ <br /> <br />Address I /11/2 1;')(/1 ~ <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I Ucense # <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Pial Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-D-W Permllfor new con~truction, <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans wi Slit Fence Installed. <br />Sanitary Facilities & 1 dumpster; Site Work P8fTT1lt for subdlvislonsl1arge projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R..Q-W Permit for new construction. <br />Minimum ten (10) working days after submittal date. Required onsile. Construction Plans. Stormwater Plans wi Slit Fence Installed, <br />Sanitary Faclllties & 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 /> <br /> FEE CURRENT <br /> COMPANY <br /> REGISTERED <br />I COMPANY <br />REGISTERED <br /> COMPANY <br /> REGISTERED <br /> COMPANY <br /> REGISTERED FEE CURRENT Y/N <br /> <br />Di~~di~~~':""" "" I................. ... II............. ow..... II.. .... <br /> <br />Fill out application completely. <br />Owner & Contractor sign back of application, notanzed <br />If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agenl (for the contractor) or Power of AlIomey (for the owner) would be someone with notarized leller from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />.,. ......... <br /> <br />.... <br /> <br />.... <br /> <br />.... <br /> <br />II .,. II .., .... <br /> <br />...."... <br /> <br />Fences (Pial/Survey/Footage) <br /> <br />Driveways-Not over Counter If on publiC roadwaysooneeds ROW <br />