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o,�-,oww�� c;iry ot�ephyrhiits Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> M fe Received Phone Contact for Permittfn D�� 8� — �b�-� '`'� 'r�3 <br /> mer's Name —.��}5L`l3 �✓ p� ��%'� Owner Phone Num6er ���— !����.�f7 <br /> rner's Address .T� S �11�— ����'L'S Ov�►ner Phane Number <br /> a Slmple Titleholder Name �—� � � Owner Phone Number i � <br /> e Simple Titleholder Address <br /> � <br /> B ADDRESS �.81�-�" e- ��l�.1„S ,-�. . ���� �.or# <br /> BDIViS10N �� ^� ���E��� ��' �� �.� aafd �r��aa �a�� <br /> (OBTAINED FROM PROPERTY T/AX Nb710E} <br /> )RK PRQPOSED e NEW CON57R� ADblAI.T � SlGN Q Q DEMOLlSH <br /> INSTAI.L REPAIR <br /> .QPOSED USE Q SFR Q COMM [� OTHER <br /> PE OF CONBTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> 8CR1PTiON OF WORK �h�RnJfr� � ltef-- ��'� %�G?�. GP,(� 'T�f� c►N,� <br /> 91.QlNG SIZE ��� 5Q�OOTAGE�� HEIGHT [�� <br /> QBUILDING �6 � VAIUATiON OF TOTAI.CQNSTRUC710N <br /> QELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING �� � <br /> OMECNANICAL $ VALUATION OF MECHANICAL INSTALLATION �'� US'' ` <br /> QGAS���D, Du [� ROOFiNG [� SPECiALTY C� OTHER <br /> IISNED FLOOR ELEVA710NS �� FLOOD ZONE AREA QYES NO <br /> ILDER COMPANY <br /> iNATURE REGISTEREb Y/ N FEE CURRE� Y/N <br /> Address Llcense# �i � <br /> cCTRICIAN C4MPANY <br /> iNATURE REGISTEREp Y/ N FEE CURRE� Y/N <br /> Address �icense# �� �� <br /> JMBER � � CdMPANY <br /> �NATIIRE REGI57ERED Y I N FEE GURRE� Y/N <br /> Address License# �� � <br /> CHANIGAL CQMPANY <br /> NATURE REGiSTERED Y J RI FEE GURRE� Y J N <br /> Address License# <br /> �ER �filY�,��LQ-!�''��,.+ COMPANY �Jg17�'I�.fS R-y�rG. L'.+�'7g�J' '�f�'fC� ��~�' <br /> NATURE � RECsiSTERED Y 1 N FEE CURRER Y/N <br /> L <br /> Address License# ��L'��� � <br /> iIDENTlAI Attach{2)Plat Pians;(2)sets of Buitding Plans;{1}set of Energy Forms;R-O-W Permit far new cans#ructlon, <br /> Minimum te�(1Q)working days after submittal date. Requlted onsita,ConstrucUon Plans,Stortnwa#er Ptans w!Silt Fence tnstalied, <br /> Santtary Fac1l�Hes&1 dumpster;Site Work Permit for subdivisionsAange projects <br /> AMERCIAL At#ach{3}complete sets of Buitding Plans ptus a Cife Safety Page;(1}set of Energy Fortns.R-O-W Perm(t for new construc8on. <br /> Minimum ten{1Q)working days aRar submCttal date. F2ec#uited onsfte,ConsVucUan Plans,Stormwatar Pians w/Sift Fence_instaHed, - <br /> - - Sanftary Facil(Ues&1 dumpstec Site Work Permit for all new proJects.All commercial requlrements must meet compliance <br /> N PERMtT Attach(2}sets of Engineered Ptans. <br /> •"`PROPERTY SURVEY requ(rec!for all NEW construc#ion. <br /> atEans: -- <br /> Fil!out appltca�Hon compietefy, ; <br /> Owner&Contractor sign back of appltcatlon,notarizer! 4 ��+ . <br /> tf ovar�2508,a Natice of Cammencement ts requlred. (AJC upgrades over�7500) __ --�.�----`�•s-, `< <'�.:y';'',- '" <br /> Agent(€or ttre contractor)or Power of Attomey(for the ownerj woutd be someone with natarized letter from owner authorizing same <br /> iR TNE CQUNTER PERMI'T'CING (Front of ApplicaNan Only) , a.. y. . ,w._..�,..-:.. _. ..-•.,�..,:.-=� . <br /> �ofs If shingles Sewens Senrice Upgrades A/C Pences{PlotlSurveytFootage} ., .,�;,;"r•.i'. �;�='_:' , -�.�,�`,:,,� � <br /> Drivaways-Not over Counter if on pubtic roadways..needs ROW � ' _;r�~�.` ::'Y' ' <br /> ��,,. ,. ...'_.,.�_,��_.,,.� ,.�.x.,., .�_�,�/.m. .�.�..•.6 <br />