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813-78U-UU2U 'City Ot Gephyrhills Permit Application rax-n1s-1esu-uuc1 <br /> Building Department <br /> r' <br /> Date Received ?' g <br /> �L4 4 Phone Contact for-Permitting Q' <br /> Owner's Name ►-f z bl L) (�� ��Y S� Owner Phone Number 13 ` V 6 7 <br /> Owner's Address 0 3 J ,SI Owner Phone Number <br /> Fee Simple,Titleholder Name- Owner Phone Numb®r, <br /> Fee SimpleiTitleholder Address <br /> JOB ADDRESS 6 d 3 �� S LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY.TAX NOTICE) <br /> I WORK PROPOSED R NEW CONSTR'= ADD/ALT 0 SIGN 0 = DEMOLISH <br /> INSTALL 'REPAIR <br /> PROPOSED:USE = SFR = "COMM = OTHER <br /> TYPE`OF CONSTRUCTION = 'BLOCK 0 FRAME = STEEL Q. <br /> DESCRIPTION OF WORK 1pv� P7P,IC C, r <br /> i q / <br /> BUILDING SIZE ZO'OTAGE (3 HEIGHT .I[ <br /> =BUILDING $ 2W dp VALUATION"OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ 7 AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY. O OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY ('n4,-e r 'r'4C-e <br /> SIGNATURE L REGISTERED Y'/ N': FEE CURREN Y-/N <br /> Address s {� Vv ' License.# <br /> i <br /> ELECTRICIAN CORAPAWY <br /> .,-'_'SIGNATURE REGISTERED I Y/ N 'FEE'CURREM Y IN. <br /> Address - License <br /> P,LUMBER.. COMPANY <br /> SIGNATURE REGISTERED .Y/`N.; FEE CURREi` Y/N <br /> Address - License# <br /> -;;`:MECHANICAL COMPANY, <br /> ` SIGNATURE' REGISTERED Y/ N FEE CURREN <br /> Aaargs- Xr.::" ,:.:, License.#:. . <br /> 77 <br /> OTHER:. '"c,OMPANY <br /> SIGNATURE: >.i ; REGISTERED Y/.N FEE CURREK Y/N <br /> Address;>,: `Cicense' # <br /> t F:: =;,s";;::.P.� Pei` tform®vir.co struction: <br /> =i=.RESIDENTIAL 'Ile GAttacFi+"(2f)Plot;P•>lans (2)sefs+of Buiidirig,Flans;(1').°sefof=Energy;Forms;"R 0=11V. rml n , <br /> :;,n;..rJ-<, Minimum;<,ten�(;10)_.working?:iiays'after suliitiittaldate.'>Required onsite;.Constructioir'Pian's,'Stotmuvater Plans w/Silt Fence,installed, <br /> ..t.. r-�... _ <br /> •�: _ SanitayryiFacilitiesn&�1�.dumpster:;;SiteWort�Permit_for-subdivisions/large�projects',°.- _ :" .. . <br /> C.OMMERCIAL Attach"2-oom-fete•sets`of BbIIdIh �Plans"lus"a Llfe Safe Pa e; 1 set of Ener Forms.R-O-W Permit for new construction. <br /> � ) P 9 P tY g ( ) 9Y <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stonnwater Plans w/Silt Fence.installed, <br /> Sanitary Facilities&1 dumpster.,Site Work Permit for'•all-,new:projects.All commercial requirements must meet compliance <br /> 'isSIGN`.PERMIT -Attach{�sets of;Erigineered4Plans; <br /> ****PROPERTY SURVEY required for,,"all,NEW construction:.•., <br /> ;.Illioukapplieation completely. <br /> 'Owner.'.&Contractorsign:back of application,notarized <br /> If over.$2500..a Notice.of:Commencement Is required. (A/C upgrades over$7500) <br /> Agent`(forthe'contractor)`orPower•of-Attorney(for'the owner)would`lie someone with notarized letter from owner authorizing same <br /> ru'OVER:THE COUNTER PERMITTING:,- .(copy_of contract.required) <br /> , <'Reroofs if;S66jiei Sewers .Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public"foadways.needs RQ '. <br />