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813-780-0020 City of Zep yrhills Permit Application Fax-813-780-0021 <br /> uilding Department <br /> , ' �'�G�i5S� �ctl.�tc�c,-1 <br /> Date�'r�eceivecl // �(�� �` � _�`�C�, <br /> � (� " � Phone Cont ct for Pe�mitting <br /> Owner's Name '1--J- �� Owner Phone Number , � - � (02� <br /> Owner's Address - � '�y� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> . <br /> Fee Simple Titleholder Address • " <br /> JOBADDRESS C(� i `�- h�\� LOT# `�� <br /> SUBDIVISION (Z�tV��.1nj I�li P CEL ID#' �J -�S���-���C -C:�QC� �G�-tCfl C'i- - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR A D/ALT ,0 SIGN 0 0 DEMOLISH <br /> � INSTALL 8 R PAIR , <br /> PROPOSED USE 0 SFR Q C MM • 0 OTHER " <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME �� STEEL � <br /> DESCRIPTION OF WORK ��� �ol��- ��a� ct�C r� H -}-:K � S�"L' <br /> I <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING <br /> VALU ION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP S RVICE 0 PROGRESS ENERGY 0 W.R.E.C. <br /> �PLUMBING $J/( G r iy <br /> !� l�s ( <br /> �MECHANICAL $ VALU TION OF MECHANICAL INSTALLATION s \�� <br /> � �� <br /> FINISH�ED FLOOR ELEVATION� ROOFING 0 F OOD ZO I E� OTHE�YES NO <br /> BUILDER I � COMPANY <br /> SIGNATURE ��-r`�n �°' �r ��r5� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I License# C..�C4��c.o(� <br /> ELECTRICIAN COMP I Y <br /> SIGNATURE REGISTERED ' Y C N FEE CURRE� Y/N <br /> Address I License# <br /> PLUMBER f I I c COMPI �U�'r�C�✓L so(C�r- ��"C� <br /> SIGNATURE - REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � � � � I License# C�VG���� 7 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDEMTIAL Attach(2)Plot Plans;(2)sets of Building Plans; 1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal d te. Requ'ired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster;Site Work Pe it for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal d te. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Pe it 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 nstruction. <br /> Directions: I <br /> Fill out application completely. � <br /> Owner&Contractor sign back of application,notarized i <br /> If over$2500,a Notice of Commencement is required: (A/ upgrades over$7500) _ , _ , , , „ . <br /> " Agent(for the contractor)or Power of Attomey(for,the owner) ould 6e.someone with notarized letter from owner authorizing same • � ' <br /> OVER THE COUNTER PERMITTING (Front of Application O�ily) `, i, � ' <br /> Reroofs if shingles Sewers Service U.p,gracles,:PJC�, ences,.(PIoUSurvey/Footage) ' <br /> . _ .. , , .: , ,. . . . <br /> Driveways-Not over Counter if on public roadways..needs RO � <br /> I <br />