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s�s-�so-oo20 ' City of Zep yrhills Permit Application Fax-813-780-0021 <br /> . uilding Department <br /> Date Received Phone Co tact for Permitting <br /> , I L <br /> Owner's Name ��� 1��� Owner Phone Number o� � °�?j� I <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address �� <br /> JOB ADDRESS ���1S � J� � �`� "'�r�"'���S �!- 3��y LOT# � <br /> , � - - . - -- - <br /> SUBDIVISION � _CEL ID# <br /> � (OBTAINED FROM PROPERTY TAX NOTICE) � <br />'I WORK PROPOSED �NEW CONSTR B A D/ALT � SIGN Q Q DEMOLISH <br /> INSTALL R PAIR <br /> PROPOSED USE [� SFR Q C MM 0 OTHER <br />' TYPE OF CONSTRUCTION Q BLOCK Q F ME 0 STEEL Q i� � <br /> DESCRIPTION OF WORK —��Ta�1Ct..'Gj Dl�l ��I" (,��I,T� �J i v� 1 i �q <br /> BUILDING SIZE SQ FOOTAGE � � LN HEIGHT <br /> �O � <br /> QBUILDING $ ��oD VALU ION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP S RVICE � 0 PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ a� <br /> QMECHANICAL $ VALU TION OF MECHANICAL INSTALLATION � ``,� <br /> QGAS Q ROOFING Q S ECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS F OOD ZONE AREA QYES NO <br /> ��l. <br /> BUILDER � i COMPANY �El�Z� �j�2U�tAYI� <br /> SIGNATURE -�i�� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 3D `�h �� „.� L 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 da e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permi for subdivisionsAarge 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 da e. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permi 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:r.equired. {A/C upgrades over$7500) <br /> :._�-.. -,.,,,... <br /> " Agent(for the contractor)or Power of Attomey(forth�.owne�)w•uld be someone with notarized letter ftom 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 />