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i <br /> I 8��-��2� City of 2ephyrhills Permit Applicatlon Fax-e�a-�eo-0oa� , <br /> ,1 Building DepaRment <br /> 1 <br /> j pate RaceNed Phona COMact for Permtttin � - � p <br /> )� � ��� <br /> , Owners Nama (f�l, (� �, �1(,�,�_ Owner Phona Num6er �/� <br /> � Qwne�'a Address {�� y E�lwrrer Phone Number � � <br /> � Fee Simple TiUeholdor Name ���lP�ne Number <br /> ( <br /> Fee Simple Tltieholder Address <br /> dOBADDRE5S t,C? � i.OT# LS�L.�� <br /> $UBDMSION PARCEL IQ# p� ' � <br /> (68TAFFiID FftOM Wt�FERTY TAX NO2tCE} <br /> i WORK pROP09ED � NEW[ONSTR 8 ADDIAI.T Q SIC3N Q Q DEMQUSH <br /> INSTALL REPAIR <br /> PROi�OSED USE ,� SFR Q COMM � OTHER ,� <br /> � TYPE OF GONSTRUC710N Q BLOCK Q FRAME � STEEL Q ��..0,� <br /> OESCRIPR4N OF WORK � p <br /> �� 2l �/� SQ FOOTAGE� HEIGHT ��, <br /> BUILDING SIZE �� <br /> 06UILDINC� 5� +„!.� _I VALUATION OF TOTAL CONSTRUCT�ON <br /> 4���J <br /> QELEGTF2tGAl $� �� AMP SERVtCE Q PR4£:RESS ENERGY [� W.R.E.C. <br /> QPLUMBING $p.� � � �G� <br /> � �J � J � ���, <br /> � � � <br /> OMECHANICAL $',pQQ VAI.UATION OF MECHANICAL INSTALIA710N � // ����� /'► <br /> � ���,� � ��f~ <br /> D�ns � RoaFEr�� p s��ciru.-rv � OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOp 20NE ARFA QYES NQ � i�� � .� �� <br /> ; a �.�► � <br /> 6UILDER �S�i.�✓\I�`Z�r,�^ � COMPANY �7�m�t...f�Jo... � ��� <br /> 9tGNATt3RE t � St I!OL�-�� rtEc,�smt�o Y t N �curt�. Y J N <br /> Addresa IIJ ✓�J"�IQ Ucense�! ",.�`� / , <br /> SiGNATURE ���„-�-� '��„�'�"'-� a��S�m 'Y/N �F�cu�..IPC�Y�+ `'y_� <br /> Address � i 1� license# ��GYcaU���� <br /> StONATURE ����� 1 4_.k_��� REGlMSTEREo Y,t N P�c� uRREn Y t P} � <br /> � � <br /> Address � P�� License# 3 <br /> MECNAHtCAL -� COMPANY � <br /> SIGNATURE �.1-� aEcis�Eo Y/N r�cuaaEn Y/N <br /> ",.... �_. . /%''� �� <br /> Address t". License#t C..J� <br /> pTHER C4MPANY i <br /> SIGNANRE aer�sreaen Y/N �cuRSEo Y/N <br /> Address L(Cense�i [ � <br /> IIIIIIIIIIIIIIIIIIIIIIIIIItllllllllllllllllllltllllllllllllllllllll � <br /> RHSlDENT►AL Adach(2}Ploi Ptans;{2)sats af 8uildi�Ptans;(i}set of Enetgy Fams;R-O-W FemtR for new conshucNan, , <br /> Minimnm ten(10)xo:ktng days after submlttai date. Required onsite,ConsVucHon Ptans,Starmwater Pians w/Siif Fence instatted, <br /> Sanflary Faa'IiUes&1 dumpster,Site Work Pertnit for subdiv'sionsliarge projects i <br /> CQMMERCIAL. Attach(3)comptete sets qf Building Plans plus a Life Safery Page;(1)set ot Energy Farms.RA-W Pertnit for ncwv canstruction. i <br /> Mintmum ten{i0}wcrkhtg days after submifYai daie.ftequlred onsita,Consttuctian Plarts,Stormwater Pter�s w!Siit Fence lastaitad, <br /> Sanitary Factlities 8 2 dumpster.SiYe Work Permit for aii new projects.A!i commerclai requirements musf ineet campilance � <br /> SIGN PERh91T Attach(2)sets of Engineered Plans, , <br /> ""'PROPERTY SURVEY required far all NEW construcdon. <br /> Dtrectiona; � <br /> FII out applicatlon completely. <br /> Owner&Conlractar sign back of applicadon,notarized <br /> If over S250D,a Notlee at Commencomant 4s naquS�ad. {NC apgrades ever S75ti0} <br /> "' Agent(for the cbntractor)or Pawer oi Attomey(for the ownsr)woutd be someone wlth noTarized ietter imm awner autliorizing same <br /> OVER THE COUNTER PERMITI7NG (Front MApplicatlon l7nly) <br /> Recoofs it shingtes Sewers Serviar Upgrades AtC Fences(PtoVSurvaytFootage) <br /> Driveways-Not over Counter K on public roadways..needs ROW <br /> l <br /> � � � , <br />