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i <br /> a�aaso-oozo City of Zep yrhills Permit Application Fax-813-780-0021 <br /> ' � uilding Department <br /> Date Received /Z -7j/-) Phone Con act for Permitting - <br /> Owner's Name .J oS� �-�� e. ✓ Owner Phone Number g�3 �y�0 �3 5(�f <br /> Owner's Address � �`� 7r .S v rh✓V►.Gr �'��!) .Ur i v Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> I . <br />' Fee Simple Titleholder Address <br />' JOB ADDRESS S 1�I S .S�m wu.r i-I�I� C��i`/2� LOT# � <br /> � <br /> SUBDIVISION P CEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 AD /ALT SIGN Q Q DEMOLISH <br /> INSTALL RE AIR I <br /> PROPOSED USE Q SFR Q CO M OTHER /�.,.ul s wc�,�< , �e c�r;�� <br />'I TYPE OF CONSTRUCTION Q BLOCK Q F ME STEEL Q ���� <br /> DESCRIPTION OF WORK ��Q�T��n-1 vp ro�{2 ��- -�avi k!I s5 W a� v\ecrl-er <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> i <br /> 0 BUILDING $ VALUA ION OF TOTAL CONSTRUCTION <br />' DELECTRICAL /o��� � /'"� AMP S VI('�E Q PROGRESS ENERGY Q W.R.E.C. <br /> ! <br /> � <br /> OPLUMBING $ \ (��I, `� <br /> ,��� - ..: S��io <br /> OMECHANICAL $ �_.__VALUA fON OF MECHANICAL INSTALLATION t <br /> QGAS Q ROOFING Q SP CIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS ; FL OD ZONE AREA DYES NO <br /> ; <br /> i <br /> i <br /> BUILDER '1 COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> I <br /> Address ! License# <br /> � � � <br /> ELECTRICIAN COMP�Y ��5� LeC��j2.t-�-e-� =� rG� <br /> SIGNATURE I , REGISTERED Y/ N FEE CURRE� Y/N <br /> Address /, I License# �bw�2 oc.���a.,r <br />' PLUMBER COMPAI�Y -�°$� L�C{��� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# o w� C�•.->� <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1) et of Ene�gy 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, <br />--`- - - - - - Sanitary Facilities&1 duinpster,Site Work Permit r subdivisions/large projects � <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Li e Safety Page;(1)set 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, <br /> Sanitary Facilities&1 dumpster.Site Work Permit r 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 con truction. � <br /> Directions: ' <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required."'(A/C v grades over$7500) I <br /> .. : �,. � � .� . �. .. .. �,....,..-.-• <br /> Agent(for the contractor)or Power of Attomey(for the owner)wou d;be someone with notarized letter from owner authorizing same .; , .. � <br /> OVER THE COUNTER PERMITTING, ` _(Front of Application Only), °' .,. ; " .- - �; i <br /> Reroofs if shingles Sewers - Seriiice"Upgrades•A/C:...,-•...Een. 's_(PIoUSurvey/Footage) g � , - <br /> ., � , „ • .. <br /> Driveways-Not over Counter if on public roadways..needs ROW I H Y_„ � . <br />