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i I <br /> a�a-�so-oozo City of Zep yrhi,lls Permit Application Fax-813-780-0021 <br /> uilding Department <br /> i <br /> � ; <br /> Date Received � � � — �5�- �S� i i __ <br /> Phone Con ct for Permitting <br /> Owner's Name � 1t� r �� �!� rn- Q� Owner Phone Number <br /> Owner's Address � `F �— ��v9 I <br /> Owner Phone Number <br /> � � <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> I � <br /> Fee Simple Titleholder Address i I <br /> , �JOB ADDRESS , i LOT# <br /> I <br /> I <br /> SUBDIVISION P CEL�ID# I <br /> I � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e AD /ALTI � SIGN Q � DEMOLISH <br /> INSTALL RE AIR 'I I <br /> PROPOSED USE Q SFR Q CO M � 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME I� STEEL Q <br /> � <br /> DESCRIPTION OF WORK °�e- �I ��' j G � � (� <br /> BUILDING SIZE SQ FOOTAGE I HEIGHT � <br /> � <br /> �BUILDING $ VALUAT ON OF TOTAL CONSTRUCTION <br /> I � <br /> i DELECTRICAL $ AMP SE VICE I 0 PROGRESS ENERGY Q W.R.E.C. <br /> �, ' �i <br /> �PLUMBING $ ' � � <br /> � I <br /> OMECHANICAL $ d,� VALUAT ON OF MECHANICAL INSTALLATION � <br /> D_ ; <br /> �l� , � � <br /> � i � <br /> �GAS 0 ROOFING Q SP CIALTY I� OTHER <br /> FINISHED FLOOR ELEVATIONS FL OD ZONEIAREA �YES NO <br /> I <br /> i <br /> I BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> � � <br /> I I <br /> Address � License# <br /> i <br /> � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> i � <br /> Address � � License# <br /> I � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ; License# <br /> �r I � � <br /> MECHANICAL COMPANY [�v g�,� <br /> SIGNATURE vv REGISI ERED Y/ FEE CURRE� Y/N <br /> Address i I License# � �� <br /> i <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> I <br /> Address � License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1) et of Enerl'gy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Requiredjonsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit f r sub'divisions/large projects <br /> COMiNERCIAL Attach(3)complete sets of Building Plans plus a Lif 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 f r all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. I �� <br /> ""PROPERTY SURVEY required for all NEW con truction. � <br /> Directions: ' <br /> I � <br /> Fill out application completely. I ' <br /> Owner&Contractor sign back of application,notarized � <br /> If over$2500,a Notice of Commencement is required. (A!C u grades over$7500) <br /> " Agent(for the contractor)or Power of Attorney(for the owner)wou d be somelone 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 Fen es(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW � , <br /> i <br /> I <br />