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silty or /-ephyrhills Permit Application Pax-813-780-0021 <br /> Building Department <br /> Date Received tilRls 4 ) "g ro . .Phone <br /> 0wrer,s Name <br /> O wner Phone Number F, _� i_,_l <br /> Owner's Address H_c_-c_ot_:T_!*e 7! Owner Phone Number F_ <br /> Fee Simple Titleholder Name W\P- Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION n Da 4ARGEL ID# X� Z <br /> I i FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDIALT SIGN DEMOLISH <br /> JNSTALL F-1 REPAIR <br /> PROPOSED USE SFR 0 COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK 0 FRAME STEEL <br /> DESCRIPTION OF WORK 'roV- �m�l I Q 4) <br /> \J — <br /> BUILDING SIZE SG1 FOOTAGE _q & HEIGHT L�� <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL F-_ AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> . I -:�-zo <br /> =MECHANICAL $ C30o VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY r\c <br /> SIGNATURE REGISTERED Y/ N ' FEE CURREN Y/N <br /> Address Te�ecmb�— License coag <br /> ELECTRICIAN COMPANY (_744dIf - <br /> SIGNATURE REGISTERED FEE CURREN IN <br /> F <br /> Address VKiLj 56n"-- 3 License# o 0 <br /> PLUMBER COMPANY Si f1 <br /> SIGNATURE o REGISTERED Y1 N FEOCURREN 71N <br /> Address S_k k1i a License#' <br /> MECHANICAL COMPANY Oro qv-S��\,4e- r- 'S <br /> SIGNATURE REGISTERED Y/'N FtECURRENV I Y/N <br /> Address 1510 TISIey- 4- t\& f2l,�,w License JcA_(_633 wq <br /> OTHER COMPANY <br /> SIGNATURE cD REGISTERED Y/ N I FEE CURREN YIN <br /> Address 3f,v�, t�,, License# Fc—(- <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 wl Slit Fence installed, <br /> Sanitary Facilities&I 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 For s.R-0-WPerm' 'it for new 'construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans wl Slit Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirbmentsr 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 Attomey(for the owner)would be someone with notarized letter from,owner authorl:[ng`sam e <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C <br /> Fences(Plot/Survey/Footage) %Z: <br /> Driveways-Not over Counter!I on public roadways..needs ROW <br />