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1 <br /> 813-780-0020 City of�ephyrhills Permifi Application FaX-a�aaao-oo21 �, <br /> � �" Buildina Department <br /> Date Rec�ived ^� <br /> Phone Contact for P�rmitting � p� — � <br /> ._.y_�..r_�_�.�..`..�.. � .. ..� . .. _ ._ _. � _ _�_�.B...j...4_ _. v <br /> Owner's Name Owner Phone Number <br /> Ow�ner's Address � � �� Ou+nee Phone Alumber <br />� Pee Simple TiUeholder Name Owner Phone fdumber � <br /> Fee Slmpfa Titleholder Address <br /> JOB ADDRESS �'-('� -y"� LOT# � <br /> SUBDWISfO�! _S PAfiCEL1D# a U O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR� ADDlALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> 'fYPE OF COPISTRUCTIOPf [� BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK � � - <br /> BUILDIiVG SIZE SQ FOOTAGE jC��-I V HEIGHT <br /> QBUILDING $ ���,�0 sry� VALUATIOIV OF TOTAL CONSTRUCTION <br /> CJV <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHAfVICAL $ VALUATION OF MECHANICAL INSTALLATION �1(�I/ � <br /> �]GAS [�` ROQFING Q SPECIALTY � OTNER _ C� ��J�� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO � <br /> BUILDER 6 , COMPANY � p � � � <br /> SIGNATURE REGISTERED N FEE CURRE� `(/ <br /> Address �b License# C�l �.� � <br /> ELECTRICIAN COMPAPlY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 1 N <br /> Addreas Llcense# � <br /> PLUi1fiBER COMPANY <br /> SIG(VATURE REGISTERED Y/ IV PEE CURRE� Y/M <br /> Address License# �— <br /> MECHANICAL COMPANY <br /> SIGNA7'URE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N F�Cuw�n Y/N <br /> Add�ess License# � <br /> IIm ➢ PfiRi11i1t � iltlltlY8A1961 ! ! 1 { ! lIIP ! llitii111QIf6t1i1l1 # 1t1Ald � � <br /> RESIDENTIAL Attach{2)plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Mlnlmum ten(10)working days after submittal date. Requlr�ed onsite,Construc8on Ptans,Stormwater Plans w/Silt Fence fnstailed, <br /> Sanitary Faalities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCiAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence instalfed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.Ali commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engfneered Pians. <br /> "*'*PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fili out application compietely. <br /> Owner&Contractor sign back of application,noterized <br /> If over$2500,a Notice of Commencement is requlred. (AIC upgrades over$7500) <br /> *` Agent(for the contractor)or Powar of Attorney(for the owner)would be someone with no#arized letter irom owner authodzing same <br /> OVER THE COUiVTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) � <br /> Drivew�ys-Not over Counter if on public roadways..needs ROW <br />