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813-780-0020 City of Zep yrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received �2 z —�S phone Co act for Permitting U�3 �0 2 — cp��� <br /> Owner's Name �V�� •'�'wr � Owner Phone Number Uv��(�13�� ��2 <br /> Owner's Address �v"f� �� � �• Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Phone Number �— <br /> I <br /> Fee Slmple Titleholder Address <br /> JOB ADDRESS �b�� ��� S t. � �11 l�S/ I�c� 3357�- LOT# � I <br /> I <br />-__-SUBDIVISION —_ - P CEL ID# �(� �" 2�� �j�O �� 2�360 � dc5 30 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) `I <br /> WORK PROPOSED NEW CONSTR A D/ALT � �`G�N � Q DEMOLISH <br /> INSTALL B R PAIR <br /> PROPOSED USE Q SFR Q C MM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME � STEEL Q <br /> DESCRIPTION OF WORK �ritl' l�T� d' fe'��"� �� •���0 � 1'(�b� bJ�/ 35 . (�-�''(e�c �(�D <br /> BUILDIIdG SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ �, 3�� VALUA ION OF TOTAL CONSTRUCTION <br />� QELECTRICAL $ AMP S RVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ �1���� <br /> � ������ <br /> QMECHANICAL $ VALUA ION OF MECHANICAL INSTALLATION \; � _ / <br /> Y <br /> C(�,�" <br /> QGAS � ROOFING Q SP CIALTY 0 OTHER <br />' ��'i <br /> FINISHED FLOOR ELEVATIONS FL OD 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 J 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 I N <br /> II Address License# <br /> OTHER � t COMPANY �"� ! �n r �C • <br /> SIGNATURE REGISTERED Y N FEE CURRE� Y N <br /> Address ,3�o`F�3 �- 5� o � ����s� rL v 3`J�I License# CC� 13 Z.�5d� <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 dat . Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit or subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Li e Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days'after submittal dat . Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit or 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 co struction. <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/C pgrades over$7500) <br /> '* Agent(for the contractor)or Power of Attomey(for the owner)wo Id be someone 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 Ee ces(PlobSurveylFootage) � - _ , <br /> :� ��� , , .. , - . . ., � , , . � <br /> Driveways-Not over Counter if on public'roadways..ne'eds ROW � _ ' , ,. - <br /> k�, • .� � , . ,,. „ . � ._`> �" � . . � ' . -. ° <br /> :3 n, ; ,,.'Js'i,,.. ,. . . _ • '`-'i <br /> i;,�..y-�y:.,!?.'`"'a;:e•.- -:r:<,a,.:.�:-.+;av:Yt�-+:e�. . �'. „ � ._ .� . . ,�,� �.�: <br /> v i ... e ,. "�S`• [, � �- . '_ _ <br /> L <br />