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- - i - . - . � r a ,s-7eo-oo2o City of�ephyrhills Permit Application � • ' �aX-e1a-�8o-oo2i , � �, " Building Depa�finent / � /� f_ ' � ��Cd.�C'�-",r'e iJ C�/'7G i/"xl{��.�.�"_Y1C%r^.�d/�. �C3!!'7 i Date Received _�_r Phone Contact for Permitting -, Owner's N'me �. �GS es ,-. � Owner Phone Number � � ��Z . �. �rv � ; Owner's A�dress la�aa�t��,��-� P'"" ��' ��r"v'}°��3� •��Owner Fhoree Number _� �,.�� Fee Simpl�Titlehalder Name �� '�,. � Owner Phone Number � � I Fee Stmple Titleholder Address �� - JOB ADDRESS ��7 (�;.G+-I"�"'��,(� � ��'�'� �""' LOT# 1� � St}BDiVISI�N ��t L �`'�f'� rr�Ca PARCEL tD# ��`✓�'�'��J" �G'��3�. Q�/OQ�G� !f[� (OBTAINEU FROM PflOPERTY TAX NOTtCEj WOFtK PROPOSED �NEW CONSTR 8 ADDJALT � SIGRI Q O DEMCILIBH , lNSTAL� REPAIR PROPOSE �)USE [�"'~ SFR Q GQMM [� O'I"HER 'fYPE OF CONSTRUCTION � S�OCK Q FRAME � BTEEL Q II DESCRIPTI,�N OF WORK I�1C� "�j�o 1'�?'�r"x-i-� L �'eT�c�t=,/�G� ✓ �✓�"��I�c�-'�"� �""'�.{�„` 1 HUtLDING�IZE � � SQ F1'�OTAGE �"�� HEIGHT �� �8�lLD1NG � i �� VALUATION OF TOTAL CONSTRUCTIQN ! DE�,ECTRICAL $ �� AMP SERViCE � PROGRESS ENERGY � W.R.E.C. " � �P��UMBtNG $ �� (�f'}�„ 1 � ��(`f�'f/ I QM ICHANiCAL $ � �d� VALUATlON fJF I+tiECNANICRL INSTAI.LATION �GAS � ROOFIN� Q SPEGIALTY �� CJTFiER FIN3SHED F IOOR E�EVATIt?NS � �� rtj ��OOD ZONE RREA QYES TVO - •a--1-1-•f-i-'fl.�i-�-:��-. ..�-r-�-�-F-i-1-�I-#-i-' '.�i�•�-i�1-1--1.�1-�f-i-1--4.1-h1-#-4y1�-l••�--E-1--1-a-. . . . . . .... ..._._�1-l-1-f.-1-. BUiLDER' I � `��f�� COMPANY �1-/•� - �v��''�""' �I'"t- SIGNATURE� REGISTERED Y/ R1 FEE CUFiRE� Y)N � ,.—.... Addres 1��'��t'��"Cc�� /� r" �� " License# ��-��'�� i q ELECTRtCI � /`�J'��r�„��„�,�,.. COMPANY ��/{ �C)+'�`�'Q''7 ��@'�-`�r� G" SIGNATURE� �"� REt3t5TERED Y/ N FEE CURRER Y J N Address ��7' � 5 1�� i�� n"'"` '�" License# �� C�� i PLUMBER I � P/�j�,��,,,._„ COMPANY l.�d!"'/"1 L�1`-��O I"2 '�-/ 11`�,.� SIGNATURE i �� `�' REGISTERED Y J N FEE CURFiER Y J N ... ..� � ' " �� L� �t� � l��.� L�L ��G �N��'�.. � Address Lioense# � MECHANICA�L ��_ COMPANY i'Y�D�r��c� i t"?�' ��r�� '�'��'� '� SIGNATURE� REQiSTERED Y J N FEE GURRER — Y/N Addressf ;,> ��`� �=.$�jie��f� �C.i�"��f�=1''� License# V 'C.��;�� OTHER i ��,�_ COMPANY �I 1 E�Gp-r'� ��C�'t- 1�"'� SIGNATURE ! REGlSTERED Y j N FEE CURFtER Y�N Addressl �''��`� f ��f' .�t" /�r� '� License# ��..�� {� 1 Iitlllilitllitltlllllllllllllltllllllllllllllllllllllllllllllllllll RESIDENTIA G Attach{2}Plot P(ans; (2)sets of Buiiding Plans;(1)set of Energy�orms;R-O-W Permit for new construction, Minimum ten(10)working days afier submittal date. Requlred onslte,Consiruction Pla�s,Stormwater Ptans w!Silt Fence instalfed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects COMMERCiAL Attach(2)complete sets of Building Plans plus a Life Safety Page; (1)set of Energy Forms. R-O-W Permit for new construction. Minimum ten{14)warking days after submittal date. Required onsite,Canstruction PIans,Stormwater Plans w!Silt Ferice installed, � Sanitary Facllities&1 dumpster.Site Wark Permit for aU new projects.AU commereial requirements must meet compliance SiGN PERMIT Attach(2}sets of Engineered Plans. ****PRQPERTY SURVEY requlred for a11 NEW construction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1--1-.i..i.�.: � ' '�-.-C-r:-f-I.i�.l-.f-1..1--4.i-1-�1-�1-i-.1-�1- !-��l..i--L-I..f.-1...' ...-.�.--.-� Directions: ` . Fi11 aut apl lication earnpletely. Owner&Contractor s(gn back of application,notarized . ' ' ' - If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) ** Agent(for'�4the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITT'ING (copy of contract required) Reroofs if shing�es Sewers 5ervice Upgrades A/C Fences(PIoUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW � .