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813-780-0020 City of Zep yrhills Permit Application Fax-813-780-0021 <br /> � uilding Department <br /> Date Received � �Z' �� Phone Con act for Permitting - <br /> Owner's Name ��� ��1 �v F-! Yl 5 Owner Phone Number .3 1 O 'N - <br /> Owner's Address � � .�f'd fJ T �� � • , �� �' 33�w�r Phone Number ��� - ���" ��'17 4 <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � a - �- � �� 1- � 3�J'�I LOT# � <br /> SUBDIVISION P CEL ID# <br /> l (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR A D/ALT 0 SIGN � 0 DEMOLISH <br /> e INSTALL B R PAIR <br /> PROPOSED USE Q SFR Q C MM , �� OTHER <br />' TYPE OF CONSTRUCTION � BLOCK Q F ME 0 STEEL Q <br /> DESCRIPTION OF WORK � �` -�' �-,-u� S �� <br /> I BUILDING SIZE c� � '�I I SQ FOOTAGE �� HEIGHT /.3 . <br /> UILDING $�,�J Q r �� VALU ION OF TOTAL CONSTRUCTION <br /> 7 <br /> ELECTRICAL $ � AMP S RVICE 0 PROGRESS ENERGY 0 W.R.E.C. <br /> t <br /> OPLUMBING $ v � � � � <br /> � � �� <br /> OMECHANICAL $ VALU TION OF MECHANICAL INSTALLATION � � ''� <br /> � 2 ��� �� �� <br /> OGAS 0 ROOFING Q S ECIALTY 0 OTHER � � ��� � <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA DYES NO Y �a���, <br /> � � <br /> J�� <br /> BUILDER � � / COMPANY ��nLP�� � <br /> ISIGNATURE ( � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> M ECHANICAL COM PANY <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;( )set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal da e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Perm t for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal d e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Perm t 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. (Al upgrades over$7500) <br /> '* Agent(for the contractor)or Powerof Attomey(for the owner)w uld be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Onl ); • � <br /> Reroofs if shingles Sewers Service Upgrades A/C F nces(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs RO <br />