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e�3aeo-oo2o City of Zephy hills Perrr�it Application Fax-813-780-0021
<br /> Buil ing Department
<br /> .a
<br /> Date F�eceived Phone Contac for Permittln --
<br /> Owner's Mame �C�►^{Y`,C � Ouvvner Phone fdumber
<br /> Owner's Address ��� ��0 «c.:S OwneP E'hone f�uro�ber
<br /> Fee Simple Titleholder fdame Owner Phone Mumber
<br /> Fee Simple Titleholder Ilddress
<br /> JO��1DDRESS �,0�� ��
<br /> SU�DI!lISIOM PA1RC L ID#
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> HH�1t6f PEtOPOSED e NEW CONSTR 8 ADD/ LT �� SIGiV Q Q. DEMOLISH
<br /> INSTALL REPA R
<br /> �6tO�OSED USE Q SFR [� COM 0 OTHER
<br /> TYPE OF CONSTRUCTIOM Q BLOCK Q FRA E Q STEEL Q
<br /> DESCRIPTlOM OF WORK G. �° (/t/(, Q ��!� ��^^ ,� v(G 1�
<br /> BUILDIIdG SIZE �(d FOOTAGE F#EIGFlT
<br /> QBUILDING $ VALIJATlO OF TOTAL CONSTRUCTION
<br /> ECTRICAL $ � AMP SER ICE PROGRESS ENERGY ,W.R.E.C.
<br /> �
<br /> U�
<br /> QPLUMBING $ ^��
<br /> •�\5 �
<br /> OMECHANICAL $ VALUATIO OF MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SPECALTY Q OTHER
<br /> FIIVISHED FLOOR ELEVATIONS FLOO ZONE AREA QYES NO
<br /> BUILDER C MPANY �
<br /> SIGIdQ►TURE R GISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAM � C MPAIdY (/� � �!C_°G ✓C G
<br /> SIGIdATURE R GISTERED Y/ N FEE CURRE� Y,/N
<br /> e4ddress � License# �� �a � 25��
<br /> PLUA118ER C MIPAIdY
<br /> SIGRIATURE R GISTERED Y/ N FEE CURRE� Y/N
<br /> �lddress License#
<br /> RAECHAIdICAL C MPANY
<br /> SIGRIATURE R GISTERED Y J N FEE CURRE� Y/N
<br /> Add�ess - License#
<br /> OTMER C {VIPANY '
<br /> SIGIdATURE R GISTERED Y/ N FEE CURRE� Y/N
<br /> A1dd�ess License#
<br /> RESIDEfdTIAL_ Attach(2)Plot Plans;(2)sets of Building Plans;(1)s t of Energy Forms;R-O-W Permit for new construction,
<br /> - Minimum ten(10)working days after submittal date. equired onsite,.Construction Plans,Stormwater Plans wl Siit Fence installed,
<br />__ _ __ � � Sanitary'Facillties 8 1 dumpster,Site Work Permit for subdivisionsllarge projects
<br /> COAIIf�lEF2CIAL �Attach(3)complete`sets of Building Plan"s plus a Life afety Page;(1)set of Energy-Forms:R-O-VVzP-ermit-for-new_constructfon_�___ , -
<br /> Minimum ten(10)working days after submi�taf date. equired onsite;Cc�is4ruction-Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facililies&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
<br /> SIGM PERIMIT Attach.(2)sets of Engineered Flans. . _ . ` , ,
<br /> ••""PROPERTY SURVEY required for all NEW cons uction. � � ' �
<br /> Directlons: . -�
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of appiication,notarized
<br /> 1(over 52500,a Notice of Commencement is required. (AIC up rades over�7500)
<br /> •• Agent(for the contractor)or_Power of Attomey,(for.the,owner)would be someone wlth notarized letter from owner authorizing same
<br /> _ ,.,�-•,�,.<.. :. .
<br /> ..�. .� „_ ,,; ., ... � � , - . , . �
<br /> OVER THE COUNTER`PERMITTING..�1".� (Front of Application Only) � �� � "�L_`'"' '°`� . -��`F
<br /> .,
<br /> Reroofs if shingles �.Sewers�- � �' SerVice"Upgrades NC.? Fenc s(Plot/Survey/Footage); ; - ; ` ,�t _ -,i
<br /> `, .. i_.. .��k ,- � :_. _ :� �'� - �� _ �
<br /> . :;. ,. '.;`''•,'', " -:'.=:...,.�. ., , , . .rr;+_ a
<br /> Driveways-Not ove�'Counte�if'on,pu6lic roadway;sivn@eds'._ROW � : i_ ,: v _ ,� �t.,.,,, ^� i
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