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813- 780 -0020 City of Zepnyrnllis rci n nL ,- , --• • <br /> Building Department /� <br /> ' --- # I Utrq <br /> Date Received I Phone Contact for P ermtttin <br /> . I l S Owner Phone Number <br /> Owner's Name ■ dK {� <br /> � ,) �� , 51 C1 Owner Phone Number <br /> Owner's Address ! <br /> Fee Simple Titleholder Name <br /> kei— Owner Phone Number <br /> Fee Simple Titleholder Address , l/ ( LOT # <br /> OI 7 0 Ll - ae C� <br /> JOB ADDRESS <br /> 6 PARCEL ID# 03 -d G -,41 - O DED Eill <br /> ��� 0 _ a 3 v <br /> SUBDIVISION 1, �� (OBTAINED FROM PROPERTY TAX NOTICE) <br /> � SIGN Q MOVE 1:1=1 <br /> DEMOLISH <br /> NEW CONSTR e ADD /ALT [� <br /> WORK PROPOSED INSTALL REPAIR <br /> COMM = OTHER <br /> PROPOSED USE El SFR BLOCK � FRAME Q STEEL Q OTHER <br /> TYPE OF CONSTRUCTION C7 <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE <br /> SQ FOOTAGE HEIGHT <br /> BUILDING $ `0d VALUATION OF TOTAL CONSTRUCTION <br /> / PROGRESS ENERGY Q W.R.E.C. <br /> ELECTRICAL $ AMP SERVICE O <br /> I 1 PLUMBING $ <br /> I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I I GAS I I <br /> ROOFING 1 1 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES NO <br /> ,_ W _ u, c , 'r • l , <br /> � COMPANY Q <br /> BUI I REGISTERED Y ! N FE CURRENT <br /> TORE ` /∎ 1 � S d am / <br /> q ?� License# ��_ _ <br /> Address ZS' ° � :: 1 73 1 Vr�1 <br /> ELECTRICIAN COMPANY REGISTERED Y/ N FEE CURRENT Y I N <br /> SIGNATURE <br /> License # <br /> Address <br /> PLUMBER COMPANY REGISTERED Y / N FEE CURRENT Y / N <br /> SIGNATURE <br /> License # <br /> Address <br /> MECHANICAL COMPANY REGISTERED Y / N FEE CURRENT Y / N <br /> SIGNATURE <br /> License # <br /> Address <br /> COMPANY <br /> OTHER REGISTERED Y / N FEE CURRENT Y 1 N <br /> SIGNATURE I <br /> License # <br /> Address I <br /> RESIDENTIAL 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. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit For subdi f0-W Permit p new construction. <br /> COMMERCIAL Attach (3) of Building Plans; set of Energy <br /> Minimum m ten en ( (10) working days after submittal date. 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 & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (A/C upgrades over $5000) <br /> ** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Fences (Plot/Survey/Footage) Sewers Service Upgrades <br /> Driveways = Not over Counter if on public roadways..needs ROW <br />