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� i � <br /> 813-780-0020 Ci of Ze h rhills Per�it A lication Fax$13-780-0021 <br /> ty P Y PP <br /> Bnitding Dsga snt <br /> Date Received phone Contad tor Pertni ngri�t�t"TflyT " <br /> —rT" �^ `,� }� p <br /> Owner's Name �(Jh� V Owner Phone Number �l+�"�p � <br /> I Owner's Address '�L 1 tj�i`t C` � Owner Phone Number p°t(c }()� "�� <br /> Pee Slmpie Tftleholder Name �� � Owner Phone Number �-� <br /> Fee Slmple Titleholder Address <br /> JOB ADDRES$ � {15�� -�`�- ~ t� i ` �/ LOT# � <br /> su�onris�aN � � PAftCELlD# � { �'2 --C� Z <br /> (OSTAtNED PROM PROPERTY TA7C ttOTIC� <br /> WORK PROPOSED e NEW CoNSTR 8 ADDlALT SIGN Q Q DEMOLISH <br /> 1NSTAlL REPAtR <br /> f <br /> PROPOSED USE Q SFR Q COMM OTHER <br /> TYPE OF CONSTRUC710N Q BLOCK Q FRAME STEEL Q <br /> DESCRIPTION OF WORK ✓^ <br /> BUILDlN6 SIZE SQ FOOTAGE� HESCyFIT L� <br /> QBUILDING �� VALUATION OF TO Al.CONSTRUCTION <br /> QELECTRICAL �S> � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> L <br /> QPLUMBtN� $('p,j'.���j� �(,� <br /> C.S�I ��"1 <br /> 6 <br /> QMECHANtCAL $ VAl.UATtON OF M }tANiCRL tNSTALLA710N s� � <br /> as� <br /> QGAS Q ROOFING Q SPECIALTY OTHER <br /> FIFt1St-kED FLOOR EtEVAT]4NS �� FLOOD ZONE REA QYES NO <br />�' BUILDER � � COMPAN <br /> SIGNATURE REOISTE Y/ N FEE CIIRREN Y/N � <br /> I <br /> Address License# <br /> ELECTRIClAN � � COMP'p-�y) -1 <br /> SIC�NATURE REi3ISTE�D Y 1 N FEE CURREK ,Y I N <br /> I .......� <br /> Address l��Yf�id�cl License# C- <br /> /� 4 <br /> � Q.6 <br /> PLUMBER COMP Y <br /> SIGNATURE ReGISTE o Y! N wt�N Y/N <br /> Address �-"L� �� I�S�t �'1.. ��i license# �f_)Z <br /> SiGNPiTi7RE �— � R a is�e o �N F�cuwxE� Y 1 N <br /> Address License# C � <br />, OTHER � � COMP Y � - <br /> i <br /> SIGNATURE r�GiSTe o Y/ N F�cuwtEn Y/N <br /> Address License# � � <br />, IIIIIIIIIIIIIIIIIIIItllllllllll'llll IIIIIIIIIIIIIIIIIIIIIIIIIIItIII <br /> RESIDENTIAt. Attach(2}Plot Ptans;(2j sets af BNtding P1ans;{t)set of En rgy Forms;R-O-W Pertnit for naw consWction, <br /> �nimum ten(10}worki�g days after submittal date. Requi onsite,ConsWction Pians,Stortnwater Plans wl Sitt Fence installed, <br /> Sanitery Facilities 81 dumpster,Site Work Permit for subdi'sionsAarge proJects <br /> COMMERCIpI. Attach(3)complate sets af Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit far new construction. <br /> Minimum ten{1 Q}warfcing days after submitta!date. Requi onsiYe,GonsWclion Ptans,Starmwater Plans w!Sift Fence instatted, <br /> Sanitary Faciiities&1 dumpster.Site Work Permit for atl ne projects.AI{commerciai requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required far all NEW consUuction <br /> Directlons: <br /> Fill out application campletely. <br /> Owner&Gnniractor sign back of appHcaBon,notatized <br /> [f over�2300,a NoUee of Commencemertt 3s requlred. {AtC upgrade aver 57500) <br /> i •' Agent(for qte contractar)or power of Attomey(for the owner)would ba so eone with notarized letter from owner authotizing same <br /> OYER THE COUNTER PERMt'[TING (Front of Applicatio»Only) <br /> Reroofs if shingtes Sewers Sen+ice Upgrades AlC Fenaes{PI Sunrey/Footage} <br /> Driveways-Not over Caunter if on public roadxrays,.neads ROW <br />