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813-780-0020 City of Zep yrhills Permit Application Fax-813-780-0021 <br /> uilding Department <br /> Date Received �" ,2��� phone Con act for Permitting b C/ —5�o�,.�'j <br /> Owner's Name � b /�'� f O �% Owner Phone Number �� � �9�—�� <br /> Owner's Address � � v��,t� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple T�tleholder Address <br /> JOB ADDRESS ~ 3 cT�o � f'l i�T 5 I LOT# � � <br /> SUBDIVISION � � V� ��. P I CEL # <br /> - �- - ' � ' ' (OBTAINED FROM PROPERTY TAX NOTICE) ' <br /> WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL B REPAIR <br /> PROPOSED USE ; Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME <br /> � 0 STEEL Q <br /> DESCRIPTION OF WORK � d � �� � f I ��j�� � •r v �•d � I2 U cs <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING °' " <br /> � ��3,Z� ALU TION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP S RVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ `��� ` ° <br /> � c����.� <br /> QMECHANICAL $ VALU TION OF MECHANICAL INSTALLATION � s� ✓ <br /> QGAS Q ROOFING S ECIALTY OTHER a G������� . <br /> 1 � 1 �' � <br /> FINISHED FLOOR ELEVATIONS � F OOD ZONE A�REA DYES NO ` ��� <br /> � �' c 1�- <br /> BUILDER � <br /> � COMPANY (�Ol�� lJ�.c� <br /> SIGNATURE 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,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Pe it for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life 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 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 /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <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 be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING•-- . (Frontof°Application On y) , ; <br /> Reroofs if shingles Sewers ' Senrice Upgrades.A/C ences(PIoUSurvey/Footage) � . - _ , .. .,, ,. <br /> , <br /> Driveways-Not over Counter if on public roadways..needs RO , ' � <br />