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�,,.,o„-�,�„ t;iry ot�ephyrhills Permit Applicatian Fax-813-780-Od21 <br /> Buttding Department <br /> ,ts R+sc�ived 3- " Phone Conlaet foc Permittln - <br /> rner's Nama Qf1 ��'��a �(� Ou+ner Phone Number U t�'�O` �.-J� <br /> rner's Address <br /> 3�� ds "�Y1 �{��'1�Y11�tS 3 OwnarPhoneNumb ��r'3 l a '' �.� ` <br /> a Slmple 74tleholder Mame �' � Owner Phone Number <br /> g Sfmple Titlehalder Address <br /> �B AdbRESS .� CT � �t'�.� �i�`—' �t 3�j�� LOT# � <br /> 18dIV1SION �_� �� PARCEI iD# r <br /> (OBTAINED FROM PROPERTY TAX N0110EJ <br /> 5RK PROPOSED e NEW CON57R -[�"�'�"" ADD/AlT �,/� SiGN Q � DEMOUSH <br /> lNS7ALL [_] F2EPAIR <br /> :OPOSED USE Q SFR Q COMM [,� OTNER <br /> PE OF CONSTRUGTlON Q Bl.OGK Q FFtAME ['� STEE� [� I~ i� � <br /> ;sc�ia�or�oF woax <br /> t cx� o i�ed�Yn, c.��oo�r�.�i� ,Y, Ctose.-�-1 ��(�G:� r�o,c��� <br /> IILDING SIZE C,�,_,_� �Q FOOTACaE� M��GHT C_ �� <br /> QBUILDING � � ,� ��� VA�UATION OF TOTAL CONSTRt1CTiON <br /> QE4EC7RICRt $ � �v�� AMP SERVtCE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ � ��� � <br /> �]MECNANICAI $ � Ov� VALUATl4N 4F MECHANICAL!NS'FA{.IATlON � � ���� <br /> OGAS [� ROOFING � SPECIALTY � OTHER <br /> 1ISHED FLOQR ELEVATIONS � � FI.OQQ ZONE AREA QYES N{) <br /> ta3a��� <br /> lI.DER � COMPANY C�1 • �-� e� <br /> iNATURE REGISTERED Y/ N FEE CURRER Y/i�l <br /> Address Ltcense# C � <br /> 7„�coC� <br /> SCTRICIAN r COMPANY �►`Vl� C���G`'� <br /> ;IdAT[fRE Q�✓�-�-"� REGISTERED Y/ N FEE CURREh Y t N <br /> Addrass �laense# { � <br /> v <br /> 1MBER E COMPANY �''�G'�.VC�} 1'1E� <br /> iNATURE ��'`�'�• REGISTEREO Y I N FEE CURREA Y/N '..Y-' <br /> Address �c. License# �� � <br /> CHANICAL J � �MPANY CS � a�i��'1� <br /> MATURE ) �.w�..•.-�-.� a-�^�+� REGISTERED Y/ N FEE CURREP Y!N <br /> Address License# � � <br /> 1ER � � GOMPANY <br /> tdATt7RE REGtST�RED Y/ Id FEE CURRE� Y/N <br /> Address License# �` ��� <br /> ilQENTIAL Attach(2)Plot Plans;(2)sets of Suildfng Pisns;(1}sat af Energy Forms;R-O-W Permit for new consbucUon, <br /> Minimum ten(10}working days after subml#tal dake. Required onslte,Constructton Plans,Stormwater Pians w!Siit Fence instailed, <br /> Sanitary Facilities&.1 dumpster;Site Work Permit far subdivisionsflarge pro�ects <br /> AMERCIAI. Attach(3)compiete sets of Building Plans ptus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new canstnsctlon. . _ <br /> Minimum ten{10)worktng days after submittal date. Ftequfred onsfte,Constructlon Plans,Stormwater P1ans wl Sitt Fence lnstatted, <br /> 8anitary Faciltties&i dumpster.Site Work Permit for aN new projects.Ail commercial requtrements must mee!campliance <br /> N PERMIT Attach(2}sets of Engineered Plans. <br /> ""PROPER7Y SURVEY requtred for a!!NEW construcUon. <br /> ctions: <br /> Fltl out eppllcation campletely. <br /> Owner&Contractor sign back af applfcation,notarized <br /> tf ovar�2500,a Notica of Commencement!s requirad. {A/C upgrades over�7SOOj , <br /> Agent(for the contractar)or Power of Attomey(for the owner)would be someone with notarized ietter from owner-authorizing.same. � :" , <br /> ;R THE COUNTER PERMITTtNG (Front of Application Only) ^i. . ' � �� �• - "' � <br /> �ofs If shingles Sewers SeMcs Upgrades,A!C - Fences(PtoVSuryeylFootage} � . • ` , ' ,' ,. <br /> Drtveways-Not over Counter if an public roadways:,needs ROW ._ �; ._ . .,.� - � ~ `"' �r � � <br />