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6IJ-/tlU-UULU c:ity ot Zep yrhills Permit Application Fax-813-780-0021 <br /> uilding Department <br /> Do!!e Receil�ed Phone Co tact for Permittin a� 37-- � Zd <br /> O�n►ner's Name �'e��'S �q�(` O Owner Phone Number <br /> Owner's Address Owner Phone Number � <br /> Fee Simpte Titleholder Name . Owner Phone Number <br /> . I <br /> Fee Simple Titleholder Address ° � <br /> � <br /> JOB ADDRESS �� —I G � U'e - LOT# �� <br /> __ SUBDIVISION ,_ _ _ _ PARCEL ID# _ <br /> (OBTAINEO FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CoNSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> B INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER �- <br /> TYPE OF CONSTRUCTIOM Q BLOCK Q FRANtt Q STEEL Q <br /> DESCRIPTION OF V110RK v , � , � Q, <br /> � � <br /> / <br /> BUILDING SIZE I LI�nJ ;� , SQ FOOTAGE f LJ� 7J HEIGHT � Q C�� <br /> QBUILDING $ �' ��^,� VALU ION OF TOTAL CONSTRUCTION <br /> v <br /> QELECTRICAL $ AMP S RVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> '�� <br /> �MECHANICAL $ VALU ION OF MECHANICAL INSTALLATION ,���� <br /> QGAS Q� ROOFING Q S ECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> BUILDER ' COMPANY �1'��9�)CC}y� S�rv�%�h G� <br /> SIGNAITURE �! REGISTERED Y/ N FEE CURREA Y/N <br /> Address 3�Sd� L!'� re r � —�, License# �.c� i3a �9 96 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE � Re��s��� Y/ N FEE CURRE� Y/N <br /> Address I License# ' <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# - <br /> AflECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGtdATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> �lddress License# - <br /> i <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-0=W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Constniction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciNties 8�1 dumpster,Site Work Permit�for subdlvlsionsAarge proJects <br /> COMMERCIAL Attach(3)complete sets of Buildfng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructton. <br /> Minimum_ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/S(It 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 co structlon. <br /> Directfons: <br /> Fill out applica8on completely. � <br /> Ovmer&Contractor sign back of applicallon,notarized <br /> If over 32500,a Notice of Commencement Is required. (A/C pgrades over�7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)w uld 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 NC Fe ces(PlotlSurvey/Footage) '` ' ���` �_,'' ".�'�;_?;;.,'�-, �• , <br /> ., - . ,- --- - �• .�_, .. • • ' <br /> Driveways-Not over Counter if on public roadways..needs ROW ._ . >. ._ v.�•..� . �•�• •--•�°- ° � <br />