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813-78MO20 City of 1-y-ephyrhills Permit Application Fox-813-780-0021. <br /> Building Department <br /> Date R®`c " d L4 for-Permittinw <br /> ....MW....... Phan <br /> Nam L/15 Owner Phone Number <br /> Owner's Name L/PnAMV <br /> Owners Address lQW0 W COR55- SA-1 owner Phone Number <br /> Fee Simple Titleholder Name. -Owner Phone Nunib6r <br /> Fee Simple Titleholder Addireis <br /> 60 q I LOT# <br /> JOB ADDRESS [�5151 <br /> --- � <br /> SUBDIVISION I tii v Nod 0 PARCEL 11014[_05 01 V a I W� MEMO -Q�ml <br /> (OBTAINED FROM PROPERTY-TAX NOTICE) <br /> WORK PROPOSED7 NEW CONST&M- ADDIALT' SIGN- 0 Q DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED-,USE 0 SFR Q. COM-M. OTHER <br /> TYPE OF CONSTRUCTION :BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK. 9CA+fv) 1 65401/ <br /> BUILDING SIZE' S4.FOOTAGk CHEIGHT <br /> N <br /> L_JBUILDING $ VALU ATIO *'0016TAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> PLUMBING <br /> 0a <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YE& NO <br /> ........ .. ... ........ <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED LjLN J FEE CURREN L_yj N j <br /> Address License# F <br /> ELECTRICIAM ': COMPANY <br /> _ <br /> SIGNATURE REGISTERED ) / N FFECURRE& <br /> Address A License:# <br /> PLUMBS COMPANY rr Uhl N <br /> SIGNATURE REGISTERED Y/,.W .- FEECuRRFK N on <br /> Address H bl I lb&fl levrm License ijL5t-Cq'(t54 <br /> MECHANICAL COMPANY <br /> SIGNATURE- RE( 4D f-Y/ N. FEE cuwta: Y 1w: <br /> Address LicensoF <br /> OTHER <br /> Y/ W.- __-FEE CURREK <br /> SIGNATURE COMPANY <br /> REGISTERED <br /> Uan'se#, <br /> Address <br /> RES <br /> IDENTIAL Attach(2),P16t.Plane,(2)wi-aBuilding P dfis;(1)S6i ofg6rgyFo'ing'-#O.Wftrrrlt for now construction- <br /> 'Plans;' - - .' ' ­ *' 4 StfF6nceIns Wlled, <br /> Stoftnwatdr lane dal:6.�R Writ!ontite,Construction <br /> Sanitary FadIIfl":&,j,,dumpsAeg.:Sltq-Work-Pemitfor.sfjbdivisiontfiftelp e_.­­:1.,.1 <br /> _ <br /> COMMERCIAL Attach(3) <br /> corno1ete'setsof ulldlfig Plans pus a Life Safety Page;(1)set of Energy Oomii.R-d-W Permitfor new construction.- <br /> Minimum ten(10)working days'after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed,' <br /> Sanitary Facilities&I dumpster.Site Work Permit for all new projects.All commercial requIrements.must meet compliance <br /> SIGN PERMIT Attactf(2)--sets dfEri 166drid,Plins.., <br /> ""PROPERTY SURVEY required-for all NEW,construction.. <br /> ................ <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. (AIC 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 /> DVER THE COUNTER PERMITTING -..(Front of Application Only) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> DrIvewa"ot over Counter If,9n public roadwdys..nieds ROW <br />