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s��-�sa-oa2o City of�ephyrhills Permit Application Fa�t-813-78Q-0021
<br /> ' Building Department
<br /> Date Received %, phone Cootaat for Permlttin
<br /> 9 �.
<br /> Owner's Name '� T(� L i ����S���Z Owner phone Number
<br /> Owner's Address 3�' �fZ,.2 L �, Qwner Phone Number �7p-G I g' / ZZ��
<br /> Fee Simple Titieholder,Name �_ � Qwner Phone Number �— �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � 5�J �3,�'�� L ,�b� , �aT# C�o�,� I
<br /> sue��rnsiarv �'�.�R.�ait� .`Rt�t�i�,',� pARCEL iD# Z�-,�Ca-�I-a�2�--a�04D-D yo
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WC1RK PROF�SED e . NEW CQNSTR 8 ADDIA�T � StGN Q Q DEMOIISN
<br /> INSTALL REPAIR
<br /> PROPOSEQ USE Q SFR Q C4MM � OTNER ' L GZ�h G �GFz'
<br /> TYPE':OF CaNSTRUGTION [� BLOCK • [� FRAME 0. STEEL [�
<br /> �. t� ,
<br /> DESCRIPT�ON OF WORK A`�A ��Q,��"pJ ��01"j D�v D j�Oc f'jT 10�.� S{�!�-D
<br /> BUll:t}1F1G S1ZE 1 Z � x�� � SQ FOOTAGE '�I � HEIGHT • f�^/��
<br /> QBUILDtNG � /��� � ti/ALUATtON�IJF TOTAL CO(VSTRLICTION
<br /> /
<br /> .:QEI.ECTRICAL $ � �� � AMP SEftV10E Q PF20GRESS ENERGY Q W.R.E.C.
<br /> QPLUf�FBtNG $ ����
<br /> .w �� � ��
<br /> QMEGNANiCAL $ VA�UATION QF MECHANICAL INSTA�LAI'!C)N ����'
<br /> � �� �%��,��� �����fi�
<br /> Q,GAS Q ROQFING � SPEGIA�TY C� OTHER �� �� �
<br /> FINISHED F1.00R EI,EVATIONS FLOOD ZONE AREA QYES O � SL �
<br /> � { l�/ �
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<br /> •8tlfi.DER �J n ` n � � 1J�CQMPANY
<br /> SIGNATURE �/Y O� "�1 �►` REGISTERE6 Y-/ N FEE CURRE� Y/N
<br /> Address -License.# � �
<br /> ELECTRl,GfAN CQMPANY
<br /> � SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> F
<br /> ` Address`� - License# � �
<br /> ,�;,�
<br /> PI:U3ilIBER;,; GOMPAtaY
<br /> SIGNATURE REGISTERED Y•/'N ` FEE CURRE� Y/N
<br /> Address Llcense# � I
<br /> . MECHAN�GAt:' � , CONIPANY
<br /> '' SIGNATURE" REGISTERED , Y/ N. FEE CURRE� Y'I N �
<br /> Add�ess�` � � ' � L•icens.e.# ��i I�
<br /> stii:., ., . — ,
<br /> .OTHER ,. ,- . , ' CQMP�WY
<br /> ?,-�'SIGNATURE;�,• `S: .�= ' REGISTERED Y/ N FEE CURREK . Y/N
<br /> , Address,�:; � . . , i. - � License# �i �
<br /> __:.`;"REStDENTlAt,-�->�At#acfi;(2}[Pio#:!?tans;=`{2j"sefsrof�Builc3ing=Pians�{1J`set=of EnergyForms;R=O=W�Ferm`it-for n�uv;cbnstructi,on; V =-- _ — —_—
<br /> _ , rt��,y;;:.=.;�;;--=:Mir�imum�;ten:(1b)�wor,kingxdays�aftersuliiriittal�date.•:Requ'ired"on'site;Ganstr`uction Plans;�Stormwater'Plans w/Silt Fence installed,
<br /> �:},.� � ' �.`� . Sanftary;Facilities,;8���1,.dumpster;:Site�Wocic:Pecrtiitfor:sitbdivisions/Iarge;pioJeets� -"- ..:�- � �
<br /> t � � - x:t 7..
<br /> ;'�:£OMMERCIAL Attach'��2}�complete sets'of'Buitclirig`Pians ptus a'L'ife+Safety Page;{1}set of Energy Forms.R-O-W Permit for new construction.
<br /> ' Minimum ten(10)working days after submittal date. Required onsite,Canstruation Plans,Stormwater Plans w/Silt Fence installed,
<br /> ' ' Sanitary Facilittes&1 dumpster._S�#e War.k Permit fo�a0 new.projects.AI!commercia!requirements must meet comptiance
<br /> `��=:&IGN��ERMIT ��Attacfi(2)sets�gf;Eng�neered.Plans.������ �- ' . - �
<br /> � ��� """"PROPERTY SURVEY required.foc.all,NEW canstrucUon:
<br /> �<<
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<br /> ,��.Directions: _ .. • .= . _
<br /> Fill:out•application completely.
<br /> 'Owner&Contractar stgn baok of applioa#ian,nofarized
<br /> `If over.$2500,a Notica�of Commencement is requirad. (A/C upgrades over$7500) __
<br /> �'- �_,,.�w,. :,
<br /> ':>'.'_� �lgent`(foC'Ui'e�cor►tiactor)'ar�Poweraf'Atibrieey{for'ttie ownef)would be someone with natarized letter from owner authorizing same
<br /> J,,;`OVER'.THE�COUNTERrPERMITTING.� ,.(copy..of-contract�required) ' `� �
<br /> �;:::'Reraofs if sliinc�les Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) _
<br /> Driveways-Not over Counter if on.�ut�lic'„�qat�ways:needs�ROW��.,'-:. ;.;,�,::'' "."''P.'"""'�`;'K"�`";:�.r..$..�� ,' .,.~'-� � "
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