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/Ua'U/Z 0 G / f✓d U/LCQ/ <br /> 813-780-0020 City of ephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> .Date Received 07i 22 <br /> /� /..� Phone Contact for Permitting Q-7 —7 <br /> Owner's Name Mar tQar t cr.�� Owner Phone Number (J r ��7V L_ (� <br /> Owner's Address O 1�/r'f"7�_ Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS / �j�(J�J/LOT# <br /> SUBDIVISION C,( PARCEL ID# / 7�'VP • !`«/�� a.;?_0 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED a NEW CONSTR e AD /ALT = SIGN DEMOLISH <br /> INSTALL REPA <br /> PROPOSED USE SFR COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME <br /> � V FRAMES k� )= STEEL = <br /> DESCRIPTION OF WORK oL V cJ S/ <br /> BUILDING SIZE I I SO FOOTAGE= HEIGHT <br /> BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ �'i/�i/10 <br /> 0I <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ! 1 <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> It II It <br /> BUILDER COMPANY <br /> SIGNATURE I Y/ N FEE CURREN <br /> 14 <br /> Address 4701f ( lx ✓ f License# 0� <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# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address I License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN I Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111111 <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 dale. Required onsite,Construction Plans,Slormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&1 dumpsler,Site Work Permit for subdivisions large projects <br /> COMMERCIAL Attach(3)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. (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 /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PloVSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />