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813-780-0020 City of Zep yrhills Permit Application Fax-813-780-0021 <br /> . uilding Department <br /> Date Received Phone Con act for Permitting _ <br /> Owner's Name ���� w G � E'Z Owner Phone Number S�� 312�9 7 1 <br /> Owner's Address �� �q �k 5T Owner Phone Number <br /> Fee Simple Titleholder Name /�w�w C ��(�'� Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �� I y TH �T ^ - ' •- _ LOT# � <br /> SUBDIVISION P CEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B A D/ALT. 0 SIGN Q Q DEMOLISH <br /> INSTALL R PAIR <br /> PROPOSED USE Q SFR Q C MM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME C] STEEL Q <br /> DESCRIPTION OF WORK � t � `��� �^�i°'°� ��`��� �o�� C-i�a✓- /=�-�- j''o�q � <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING $ ���Q oa VALU TION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP ERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> �Sa�? <br /> QMECHANICAL $ VALU TION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q S ECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA �YES NO <br /> SIGNATURE �� COMPANY / `�'�'�' r'� w C L o e 'Z <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <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)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal d te. Required onsite,ConstrucGon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Pe it for subdivisions/large 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 8�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: <br /> Fili out application completely. <br /> Owner 8 Contractor sign back of application,notarized � "� � <br /> If over$2500,a Notice of Commencement is•requ7red.:;(A/ _upgrades over$7500) <br /> " Agent(for the contractor)or Power of Aftomey,(fo�tfi'e owner)=�oulii be;someone with notarized letter from owne�authorizing same �- ��._� - <br /> OVER THE COUNTER PERMITTING (Front:of Application O ly,)' '� : - � <br />, Reroofs if shingles Sewers Service Upgrades A/C en�es(PIoUSurvey/Footage) a , _ <br /> Driveways-Not over Counter if on public roadways..needs RO , M'y �� <br />