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813-780-0020 City of Zep yrhills Permit Application Fax-813-780-0021 <br /> uilding Department <br /> Da7e Received Phone Con act for Permitting — <br /> Owner's Name �U ,$' Gr� j��/�- Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> I Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��ya� �3��ZJ� aNc� /�d � �O 2(���O Z Z� �7"/�l.f'r' LOT# � <br />' SUBDIVISION P <br /> CEL ID# <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br />' WORK PROPOSED NEW CONSTR A D/ALT 0 SIGN Q Q DEMOLISH <br /> � INSTALL B R PAIR <br /> PROPOSED USE 0 SFR Q C MM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME � STEEL Q <br />� DESCRIPTION OF WORK 'S` L�l'�%�/i' Gs�v� � �— Cs4�i9�i✓ Lliv�� <br /> ' � ��- ` <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING $ VALU TION OF TOTAL CONSTRUCTION <br /> f.�s4, o 0 <br /> I DELECTRICAL $ AMP ERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ / <br /> Sc�qs <br /> OMECHANICAL $ VALU TION OF MECHANICAL INSTALLATION � <br /> � <br /> OGAS Q ROOFING Q S ECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> BUILDER / // .� COMPANY /Ts�° F�NG'G� C c /`./ C <br />'I SIGNATURE �i��^-e�L?j--- REGISTERED Y N FEE CURRE� N <br /> Address 2,S L u�� S � 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 />� <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 ate.�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 Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal ate. 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. ( C upgrades over$7500) <br /> "" Agent(for the contractor)or Power�of Attomey'(fdP tHe"owner)` ould.be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIiTING , (Front of Application 0 ly) <br /> Reroofs if shingles Sewers : S'ervice Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs R � I <br />�i <br />