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s�s-7so-oo2a City of�ephyrhills Permit Application F�-a�s-7so-oa2�
<br /> � Building Department
<br /> Date Receive� �/��/7 phone Contact for Permittfng ,
<br /> Owner's(Name ` L.. � � �'� Owner Phcne umber U ��/
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<br /> Owner's Address � L.�- Owner Phane Number D l,.,J l �J V/ ,YJ (!�( I
<br /> Fee Simpte Titleholder Name � � Owner Phone Number �� �
<br /> Fee Simple Titleholder Address
<br /> J08 ADDRESS � V ILiT# �,�
<br /> SUBDiVIStON � � PARCEG lD#
<br /> (OBTAIWED FROM PROPERTY TAX NOTICE) �
<br /> WORkC PROPQSED NEW CONSTR ADDlALT � SEGN Q Q QEIV10[.ISH
<br /> � INSTALL 8 �REPAiR
<br /> Pl30POSED'USE � SFR Q CQIWM � OTHER
<br /> TYPE'OF CONSTRUCTION Q BLOCK - Q FRAME. 0. STEEL -Q
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<br /> DESGRiFT10N OF WORK t t 1 U U U
<br /> BUII:DING SIZE . �t� +f�0� SQ FDQTAGE tt/ • I�E[GFtT • ,,,U b0� �
<br /> BUILDING $ ��J J r� �/ALUATION=OF TOTA�CCiNSTRUCTION
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<br /> •:QELECTRICAL (;& � AMP SE12VtCE Q Pl2QGRESS ENERGY [� W.R.E.C.
<br /> c;' �
<br /> OPLUMBING � � ��
<br /> QMECHANlCAL $ VALUATtON QF MECHANlCAL INSTALLATIt�N � �
<br /> � �
<br /> QG/�S Q ROOFING Q SPECIAl.TY C� OTHER
<br /> FINISMED FLOOR ELE AT FL.00D ZONE AREA QYES NO
<br /> BUIE.DER � COMPANY � �Lv1�/j1U�
<br /> S�GNATURE l REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � -License,# �- �
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<br /> _ 'ELEGTRI,GIAN . COl41lPANY •
<br /> . SIGNATURE REGISTERED Y/ N FEe cURRen Y/N.
<br /> ., Aifdress � - License# �� '� �
<br /> PLUMBEE2.;: , r COMPANY
<br /> SIGNIA,�I�URE _ REGISTERED , Y-/'N �.FEE CURRE� Y/N
<br /> Acldress � License# �^ �
<br /> �`MECHi4N1CA1: � COMP.ANY
<br /> '' SIGNATURE•'= REGIS7ERED , Y/ N - FEe cuw�en- Y/N
<br /> Address�" ' L•icens.e.# �� ��
<br /> ;:a:.. _ ... —
<br /> �..OTHERa�"_.`;- � ' , � C,O((IIIFANY
<br /> ';�`-''SIGNA°IiURE:i+��<: .�� - - - REGISTERED Y/ N . FEE CUftREK � Y/N
<br /> ' �Address�: , .�" .. Ucense# � �
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<br /> ���...' µ -.. ... , r' ' .� •a�::" .: .� , "i._5� a ..�. ._ _. , . .,, , .+ �� � � �
<br /> ��nRESIDENTiAl.�;�5 'Attiach;{2}'Ptot:P,lans;:{2}�setsaf'Buiiding�Plans;{1}°set of�Energy'Foi tns;R=0-�1!.Perinit.for new.construction,
<br /> _ =,4• �;��;.}.,;�a�,,�-•>Minimum;ten._(,10),yu,o`rking,days:;afte��su6inittal.dafe. :Required onsite;Canstriictian Plans;Stormuvater Plans w/Silt Fence installed,
<br /> t�:�- - SanitarytFacilitiesr,&;1,�.dumpster;.Slte�.:Wgrk Permlt for<subdivisionsllarge;projects�` " -` �- � �
<br /> :=�GOMMERCIAI. A#tach�(2}�complete`sets of Bu�Id�ng Plans pius a Cife Safety f'age;{4}se#of Ene�gy Forr»�s.R-O-W Pecmit for new construction.
<br /> >�t:-:.
<br /> =' � Minimum ten(10)working days after submittal date. Required onsfte,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> �';' Santtary Facill8es&1 dumpster.,Site,Work Permit fo��al!-new piojects.AA cammerciat requireme»ts mast meet compliance
<br /> :"'SIGN�:AERMIT ";4ttacFi(2}seEs oft'Engjneered�Ptans:==� �•� ��. � - •�
<br /> ""'"pROPERTY SIJRVEY requiretl for aII,NEW construction.- _
<br /> ''=n0icecttoris: +� . ;_., � .
<br /> -z. Flll.out�application completely.
<br /> ','� Ou+mer&Contractor sign.track of appiication,nota�ized
<br /> ' ff oVer$250d,a Notice of Commencement is required. (A/C upgrades over$7500)
<br /> "'''"`: A ent'for'the�contractor�or.�Power•:of'Attome fot'the owner ,wauld'be sameone with natarized letter fram owner authorizin .same = �
<br /> 9 � ) Y� ), , 9 , .:
<br /> . r_,...- � _ - �
<br /> :,'.OYER;i'FtE-COUNTEt2�P..,ERMiTTtNGr._. ,,.,.(coPY.of:cantract required);�; � " . ..- , , .
<br /> ?;;�Re�ooff�if sfifngles Sewers Service Upgrades;A/C' � ` Fences(PIoUSurvey/Foatage) ; ' �- '�, .
<br /> ,; Driveways-Not over Counter if on;public�roadways.:needs ROW , - + , ' ' . L ,
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