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s�aaso-oozo _ - City of Zep yrhills Permit Application Fax-813-780-0021 <br /> T �_._ uilding Department <br /> Date Recetved Phone Con act for Permitting — <br /> Owner's Name �D 'o�U'n � Owner Phone Number <br /> Owner's Address �� � ��,' �l.J Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��.J 1 �/`-'e � LOT# � <br /> SUBDIVISION I� Y1 0� P CEL ID# I ��(/'v�� �-O I o�o�������—�7�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) � ' <br /> WORK PROPOSED e NEW CONSTR B A D/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL R PAIR <br /> PROPOSED USE Q SFR Q C MM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q F ME � STEEL Q <br /> DESCRIPTION OF WORK � V °v ` \'2- <br /> BUILDING SIZE SQ FOOTAGE i (� HEIGHT �C7 <br /> QBUILDING $ '� a� O f VALU ION OF TOTAL CONSTRUCTION <br /> �� <br /> QELECTRICAL $ AMP S RVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHANICAL $ VALU ION OF MECHANICAL INSTALLATION � ��v� <br /> � <br /> QGAS Q ROOFING Q S ECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> s <br /> BUILDER COMPANY `U�.�*�.1'i7 pb�1V�Q <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� /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;( )set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal d e. Required onsite,Co�struction Plans,Stormwater Plans w/Silt Fence installed, ___ <br /> Sanitary Facilities&1-dumpster;Site Work Perm t fo�subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a ife Safery 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. (A/ upgrades over$7500) <br /> *" Agent(for the contractor)or Power of Attomey(for the owner) uld be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Onl ) <br /> Reroofs if shingles Sewers Seroice Upgrades AIC F nces(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs RO <br />