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p,,,-,�„-,,,,�� c:ity ot Gephyrhifls Permit Apptication Fax 813-�$o-ao2� <br /> Bullding Department <br /> � :�e <br /> te Recelved phan�Contaat for Permittfn <br /> rner's tdame � `�� {L� Owner Phone Number �� J " t �� ^��1 �� <br /> rner`s Address �C��� Owner Phone Number <br /> a Slmple Tlttehotder Name � � � t3wner Phone Number �� <br /> e Stmple TlNeholder Address <br /> B QODRESS LOT# C� <br /> aoi�ns�o� � � P�ce�.�o# � � �- 2 6 - 2 l _ �-1 S`2 t?e°-D�6 <br /> (QBTAINED PRpM PROPER'TY TAX NQTtGE) <br /> )RK PROPbSED � NEW CONSTR� ABD/ALT �� S1GN [� [� DEMOLISN <br /> 1NSTALL REPAIR <br /> .OPQSED USE C] SFR Q GOMM � QTHER r+"1 � � ' <br /> PE OF CONStRUCTtON Q B�OCK � FRAME � STEEL [�] <br /> SCRIPTIQN OF WORK ����1 �'�'T �'" <br /> �l1.DING StZE � � SQ FOOTAGE�� HEIGHT C_,^� <br /> �8���-d�N�'' r'_`��� � VALUATIQN OF TOTAL CONSTRUCTIdN <br /> L <br /> [�EIECTRlCAt �� AMP SERVICE [� PROGRESS ENERGY [� W.R.E.C. <br /> QPLUMBING $ �`�1 <br /> [�� �;5r' ,r,,,,,.s <br /> QMECHANICAL $ VALUA710N OF MECHANlGAL INSTALIATlQN � `/� � <br /> �.�/ 5 <br /> QGAS Q ROOFING Q SPECIAL'TY � OTHEft � /�,l�� <br /> G <br /> iiSHED FLQOi2 ELEVATIONS C�__� FLOOD ZC3NE AREA �YES NO � <br /> .o <br /> i�.Q�R --'`'`� c PaNir �.�-1� `��S�-�, �1.�J.m�,�� <br /> 3NATURE � REGISTERED Y/ N FEE QURRE� Y/N <br /> .----- <br /> Address ��S� "�C� R� Llcense# �`� `� <br /> ECTRICIAN � CdMPANY <br /> �HATlJRE REGISTEREp Y! N FEE CURRE� Y/N <br /> Address License# �_ �� <br /> JMBHR � � C4MPANY <br /> �NATURE REGiSTERED Y 1 N FEE CURRE� Y/N <br /> Address License# r- �� <br /> CHANiCAL COMPANY <br /> NATURE REGlSTERED Y i N FEE CURREF Y/R) <br /> Address Ltcense# � � <br /> � iER � � COMPAt�Y <br /> � NATURE ( REGISTEREb Y/ (V FEE GURREA Y l N <br /> Address License# ��ir�] <br /> ilDENTiI�t. Attach(2)Ptat Plans;(2)sets of Building Atans;(1}set of Energy FoRns;R-O-W Permit for new constructlon, <br /> Mtnimum ten(1d}working days after submittai date. Required onslte,Conshuotion Plans,Stormwater Plans w!SAt Fence installed, <br /> Sanitary FacitiBes&1 dumpster;Site Work Permlt for subdivisionsilarge projects <br /> �iMERC1Ai. Aftach(3}complete sets of Building Plans plus a t�tfe Safety Page;(1)set of Energy Forms.R-O-W Permlt for new construcdon. <br /> Minimum ten(10)working days after submittal date. Requlred onsite,Constructian Plans,Stormwater Plans w!Sili Fence insta!led, <br /> Sanitary Faciiities&1 dumpster.Stte Work Permit for all new proJects.All commercia!requlrements must meet compliance - ' - <br /> F1 PERMiT Attach(2)sets af Engineered P1ans. " - <br /> "*'"PROPERIY SURVEY requtred for ail NEW construoUon. <br /> ctians: <br /> Filt aut applicaUon comptete�y. <br /> Owner 8 Contractor sign baok of applfcatfon,notarized <br /> if over�2500,a Nottce of Gommencement Is requtred. (AIC upgrades ouer�T5Q4) <br /> Agent(for the contractor)or Power of Attamey{for the owner)wavid be sameone with natarized letter from owner authorizing same <br /> iR THE COUNTER PERMITTING (Front of Application Only) <br /> �ofs if shingles Sewers Service Upgrades A!C Fences{PlotlSurveylFootage} <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> � . <br /> I <br />