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812=7sM029 City of�ephyrhitfs'Rermft Appftcation Fax=813=780.0021 <br /> Building Department <br /> Date Received S� ZIP ?6 (/ <br /> 2_ la <br /> Phone Contact for Permitting vv <br /> •_Ownees�Name 1 -_OwneCPhone•Number 1 ^7 <br /> Owner's Address 4'L60 W d _Tnq1eu CApwner Phone Number 1 �' <br /> Fee Simple Titleholder Name F L Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS S/S7 G Yth 5 ra,,L <br /> rti,115 P 3r1f LOT# <br /> _SUBDIVISION _ PARCELID#' I Z —2 — Owe)^/5bI!o'01&0 <br /> 'jOBTA1NEO-FROM-PROPERTYTAX NOTICE)WORK PROPOSED NEW CGNSTR ADDlALT SIGN DEMOLISH <br /> eINSTALL REPAIR <br /> PROPOSED USE FV) SFR 0 COMM OTHER <br /> TYPE OF CONSTRUCTION` 0 BLOCK �" FRAME � 'STEEL <br /> DESCRIPTION OF WORK / �O <br /> Roof- <br /> BylLql SIZE - SQFOOTAGE .:. HE10KY.. ;.. <br /> QBUICDING $ VALUATION OF TOTAL CONSTRUCTION <br /> 0 ELECTRICAL $ AMP SERVICE PROGRESS ENERGY Q_ W.R.E.C. <br /> QPLUMBING $ <br /> C�, <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROfl61NG 0 SRECIAL.TY 0 OTHER J ��J1� 4I ' <br /> -FINISHED-FLOOR ELEVATIONS TLOODZONE'AREA DYES -NO kl v C 'I VI W'(/ <br /> _t3Uli3?ER 'TapAt <br /> SIGNATURE REGISTERED Y/ N FEE C'URREt N <br /> Address GatLicense# <br /> E�ECI 111CIANF COMPANX <br /> SIGNATURE' REGISTERED J, Y/ N I FEE CURREN Y/N ' <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y!N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREK Y PN <br /> :Address. if cense1: <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURREN YIN <br /> ;A00ss tioense#_. <br /> I0110000AIII00AIA01000111AA0110110A0.001110110A901001001011100010011 <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(1'0)working days after submittaFdat6. Required orisita,Constiuction Plans,Stormwater Plans W]Silt Fence irist6fed, <br /> Sanitary=Facilities:&:1_dumpster.=Site:Wdrk=Permitfor_bit new.prbjects:'All-commarclal requirements Mustmeetcompliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ***PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application comptetely. <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(far the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> .:Reroofs.f shir1es Sewers Service Upgrades A/C ,Fences{Mot/Survey/Footage) <br /> 701riveways=Not over Countee f on public roadways..needs-ROW <br />