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�"'`��� a�s-�eo-oozo Cit of Ze h rhills Permit A lication Fax-813-780-0021 <br /> i� % Y p Y PP � <br /> Building Department <br /> Date Received ..� � �` phone Contact for Permittin >.3 �%�/ -- �/ � �v/ <br /> Dwner's Name ��" ov� ;,S'B �'"7 �v�� � /�.fs� Owner Phone Number �� p <br /> Owner's Address :Sp� U ✓ Z • ,3`� Z pymer Phone Number � <br /> Fee Simple Titleholder Name �n —� Owner Phone Number � <br /> Fee Simple Titleholder Ad,�ses;-=•�\ <br /> ,� <br /> .JOB ADDRESS i�J �^� SSU��1 G'" �� ' I/ _-----..._ __-- , <br /> :SUBDIVISION � PARCEL ID# S � ft' �('��� '�l����'� (�� J!! ` <br /> �._..` ROPERTY TAX.HDIIGE)__._...___.._......._. <br /> 'WORK PROPOSED B NEW CONS7R e ADD/ALT �]] SIGN Q Q DEMOLISH � <br /> INSTALL REPAIR <br /> IPROPOSED USE Q SFR Q COMM � OTHER <br /> 'TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> IDESCRIPTION OF WORK � fJ c' /7/� � <br /> �UILDING SIZE J��O Q �!- gq FOOTAGE HEIGHT � <br /> QBUILDING $ • A� VALUATION OF TOTAL CONSTRUCTION <br /> ��a <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING � � � ' <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ,� ( � <br /> � 1 <br /> QGAS � ROOFING Q SPECIALTY Q OTHER <br /> f=1NISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> dU1LDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � —� <br /> MECHANICAL � COMPANY <br /> �IGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address — License# � <br /> QTHER — COMPANY �—(��e �� OQ /� �' <br /> SIGNATURE REGISTERED Y N FEE CURRE� Y/N <br /> Address fA � /'r-Si �'�� •! �C � ''���� � � License# ��.s .J/�✓—� <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bufiding Plans;(1)set of Energy Forms;R-O-W Permit for new consVuction, <br /> Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)comptete 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. Requfred 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 consVuction. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of application,notarized <br /> if over:2500,a Notice of Commencement(s required. (A/C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter hom owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />