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813-780-0020 City of�ephyrhills Permit Application Fax-813-780-0021 <br /> + Building Department <br /> Date Received A I Phone Contact for Permitting -/ �{ <br /> Owner's Name l�/o y./)[� 0 /1 -a Owner Phone Number �1 ' 7" - 7 r. 7 <br /> Owner's Address q 1 t �l e D,f• Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS SG M C. LOT# <br /> SUBDIVISION PARCEL ID# _ . V `'�� -a 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT �SIGN = = DEMOLISH <br /> R INSTALL e REPAIR <br /> PROPOSED USE = SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION Q // BLOCK = FRAME = STEEL = <br /> DESCRIPTION OF WORK 4, e l/ CO/1 // 1 i/l A rl" 44/LP.�� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> liffiIiiiii <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING $ <br /> �UZECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I - License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# f / <br /> MECHANICAL COMPANY P-10V 6n� fl rpA.t! <br /> SIGNATURE l REGIST/EREDD Y/ FEE CURREN L4N <br /> Address �lP� � �'IZ,,,,/,l i ! C ►'-L � 5� License# 1-7 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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 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 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 for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> " Agent(for•.the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles \Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />