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613-78U-0020 City of Gephyrhills Permit Application rdF.-019-1OV-W— <br /> / . Building Department <br /> Date Received ,Zi� �L .Phone Contact for Permitting <br /> Owner's Name ���'-C v1 Vu C'i[t7 Owner Phone Number , 0�.7 Vim! - <br /> Owner's Address Ir / + �� Owner Phone Number ��..�• �' <br /> Fee Simple;Titleholder Name OwnerPhone Number <br /> Fee SimpleiTitleholder Address J � <br /> JOB ADDRESS Qv- h LOT# <br /> SUBDIVISION Cr�� r� fi PARCEL ID# / -- a l - Ov `- -- owo <br /> (OBTAINED FROM PROPERTY.TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR' ADWALT LJ SIGN = = DEMOLISH <br /> e INSTALL B `REPAIR <br /> PROPOSED USE. = SFR = COMM = OTHER <br /> TYPE:OF CONSTRUCTION = BLOCK 0 FRAME = STEEL Q. <br /> yti r V <br /> DESCRIPTION OF WORK l J ),v',k&', r ay y S Lr.Zz� 1" •Cd , •`�- / ' <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $ VALUATION'OF TOTAL CONSTRUCTION <br /> d� <br /> ELECTRICAL $ Boa AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> PLUMBING $ <br /> jr <br /> =MECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> :BUILDER �OIIAPANY UI v :J(`J /�17r✓� ' <br /> SIGNATURE REGISTERED Y/ N: FEE CURRE� Y/N <br /> Address o �� License.# 60 <br /> 'ELEC,TI2ICIAN ,S COMPANY l�G'`AS. C <br /> ---SIGNATURE REGISTERED N FEE; URREN /N. <br /> Address Ida�L us 1 Dgk 3 SA_ <br /> License# �C ��d����73a <br /> ' PLUMB ER.;. / MPANY - (Z � k- <br /> SIGPIATURE" " REGISTERED Y,/ N. FEE CURRE� N <br /> Address License# Fcrc i 2 <br /> 'MECHANICAL- COMPANY• <br /> ` 'SIGNATURE REGISTERED Y/'N FEE CURREN _ Y/N <br /> Addr®is':,-= License.# <br /> OTHER;.`.:,; COMPANY <br /> SIGNATURE:;:: s REGISTERED Y/.N FEE=CURREK <br /> _ . Address,:. <br /> RESIDENTIAL fi•$ Attach"2, PloIt: ans 2 sefs of;Buildin 1?lans; 1 set'of Enet' 'Forms;R O=VV:Perr►iit for new.constiuction,. <br /> Minimum-teq(10)workings'days:aftersutirriitta1.date." Requiired onsite 'Construction Plans,`Stor nwater Plans w/Silt Fence installed, <br /> SAn.16 Facilities&1ti.dumpstef;Sife Work;Kermit,forsubdivisions/large-:projects',.:. <br /> ;,:COMMERCIAL Attactr(2)complete'sefs of Building Plans plus a Life 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,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit foil all•new-oeojects.All commercial requirements must meet compliance <br /> cSl N:PERMIT Attaofi(2j sets of,Engineered PIansc�� <br /> - <br /> ""PROPERTY SURVEY required,for.all,NEW.-construction. <br /> ,DlrecU6 s: <br /> `Fill:out`application completely. <br /> Owner'&'Contractor sigmback of application,notarized <br /> If over:$2500;.a Not)ce.of:Commencement is required. (AIC upgrades over$7500) <br /> Agent(f6t�the',dbdtradtoc)�or,Power_of-Aftomey(Mr'the owner)would lie someone with notarized letter from owner authorizing same <br /> ? OV.EI3;THE COUNTER PERiiAITrIMP,..,.;.,. ..(copy.oUcontractxequired) " <br /> "Reioofs if Shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter-if on-public'roadways:needs ROW <br />