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I , 813-780-0020 �— Fax-813-780-0021 - � <br /> City of Zep yrhills Permit Application <br /> uilding Departmenf <br /> �� <br /> i � � f <br /> Date Received � + �Z�-�' phone Con act for Permitting �� ce� -- ��� <br />,� Owner's'Name � � 1� � o�N�J � � �� Owner Phone Number � < d '���� <br /> iOwner's Address J ` L �{ N► /7�/L Owner Phone Number <br /> I <br /> I <br /> Fee Simple Titleholder Name Owner Phone Numbe� <br />� Fee Simple Titleholder Address <br /> JOB ADDRESS d 7 //CU OM �/io'C LOT# �� <br /> SUBDIVISION �P�'�� oP�'d Q� . PA CEL ID# �� 's�l�'��° ��/ �� O���o ��> O <br /> ' (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR B AD /ALT 0 SIGN � � DEMOLISH <br /> INSTALL RE AIR <br /> PROPOSED USE' � SFR Q CO M 0 OTHER <br /> TYPE OF CONSTRUC710N � BLOCK Q FR ME � STEEL 0 <br /> DESCRIPTION OF WORK /�/+��0 u�l �� C d� � G�/�R y� /J.� Pi'l �� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> OBUILDING � ; �f �� VALUAT ON OF TOTAL CONSTRUCTION .�����J <br /> �—l1 <br /> �ELECTRICAL $ AMP SE VICE � PROGRESS ENERGY � W.R.E.C. <br /> �PLUMBING $ <br /> � N�e�,G��/ <br /> OMECHANICAL $ VALUATI N OF MECHANICAL INSTALLATION � -\'"' � <br /> � � � � <br /> �GAS 0 ROOFING Q SP CIALTY � OTHER �/� � <br /> FINISHED FLOOR ELEVATIONS FLO D ZONE AREA DYES NO� <br /> BUILDER , , , i, I� '✓ OMPANY ���d pt�/ �Ci'/ o� � �J � <br /> SIGNATURE V EGISTERE� Y N FEE CURRE� /N � <br /> Address D �is•�lair� ,� �/f - , License# ��G, �,�r/�J9 <br /> ELECTRICIAN ' OMPANY <br /> SIGNATURE r EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> � <br /> PLUMBER � � � OMPANY <br /> SIGNATURE e�isTeReo Y/ N FEE CURREt� Y/N <br /> Address License# r— <br /> MECHANICAL OMPANY <br /> SIGNATURE � EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# '' <br /> OTHER OMPANY <br /> SIGNATURE �EGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL 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. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, i <br /> Sanitary Facilitie�8�1 dumpster;Site Work Permit fo subdivisions/large projects <br /> COMMERCIAL Attach(3)compiete sets of Building Plans plus a Lif Safety Page;(1)set of Energy_Forms.R-O-W-Psrmit-for new consiruction. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConsYruction Plans,Stormwater Plans w/Silf Fence installed, <br /> -_ --- -- - Sanitary Facilities�1 dumpster.Site Work Permit fo all new projects.All commercial requirements must meet compliance <br /> SVGN PERMIT �ttach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW const uction. <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 up rades over$7500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)woul be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fenc s(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />