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813-780-0020 City of Zep yrhills Permit Application Fax-813-780-0021 <br /> Building Department � <br /> ,�� . <br /> Date Received a ��, ��/ Phone Co tact for Permitting ���j q� - Co r'u�J <br /> Owner's Name /�e Owner Phone Number l' � D -�J' <br /> Owner's Address 4�Q l,�r 5���e���i� h� Owner Phone Number 0 �6 - ,3 <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> � <br /> JOB ADDRESS J 7 Y Z v C 4 S'F�� b e��► `� � o� LOT# � <br /> SUBDIVISION P CEL ID# �� ' Z` ' 2� � Ol Z O " o� ' �6�O <br /> - - - - - -- - - - -- - - (OBTAINED FROM�PROPERT-Y_TAX N0710E)_� - __ _. ___ _ �__ _ _,_ _ <br /> WORK PROPOSED NEW CONSTR A�D/ALT � SIGN Q Q DEMOLISH <br /> e INSTALL e REPAIR <br /> PROPOSED USE Q SFR Q CQMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK � r� rJ% �� IO✓1 <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> OBUILDING $ VALU TION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP ERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHANICAL $ VALU TION OF MECHANICAL INSTALLATION � '���S <br /> 3��� <br /> OGAS Q ROOFING Q S ECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> BUILDER COMPANY <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 /) B Z�E1QNi N L C <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 Permit 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 d te. Required onsite,Construction Plans,Stormwater_Plans w/Silt Fence installed, <br /> Sanitary Facilities 81 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 applicatian completely. , _ _. <br /> Owner&Contractor sign back of application,notarized � '� ` r <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 ftom owner authonzing same:-., ., �,;t� _, _' <br /> OVER THE COUNTER PERMITTING (Front of Application On y), , , ,_, ' , - - , ,; ' ' , <br /> Reroofs if shingles Sewers Service Upgrades i4/C' nces;(FIoUSurvey/Footage)' � ' � - � <br /> . ; • ' , .._, „_ . • :i <br /> Driveways-Not over Counter if on publiaroadways..needs RO ��,� s ' ; „ ;', _ `",,,, '_,,,� ,n,., <br /> _ .... .... .:.. ..�:r."s <br />