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city of/-ephyrhills Permit Application Fax 81 3-780-0021 <br /> Building Department <br /> Date Received sbe�vPhone Contact for Permitting C)r\)Qkak <br /> Owner's Name lo n Owner Phone Number <br /> 19(0 <br /> Owner's Address uim I 33 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address F <br /> L,..r <br /> JOB ADDRESS 1.0 2an LOT# <br /> SUBDIVISION (y YO- W 7_00- C)C <br /> �ARCEL ID#F (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN 0 DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE 0 SFR COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK 0 FRAME STEEL F7 <br /> DESCRIPTION OF WORK W 1Ocl S a 4) <br /> BUILDING SIZE SQFOOTAGE�� HEIGHT <br /> a a A 1 7 r-r <br /> =BUILDING 1,P Wo VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE PROGRESS ENERGY Q W.R,E.C. <br /> =PLUMBING <br /> =MECHANICAL ' i$ <br /> VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> V v v v W V I V a V <br /> BUILDER' COMPANY FEE CURREN <br /> SIGNATURE REGISTERED <br /> Address V?1,07 Te e License# EaW,;9C&2 2— <br /> P-d'ec4�1te <br /> =LECTRICIAN COMPANY <br /> SIGNATURE REGISTERED FEE CURREN Y/N <br /> Address a4,A -_5223�. License# C, o bs <br /> SLUMBER COMPANY <br /> 33IGNATURE REGISTERED Y1 N FEEIbURREN 7IN I <br /> Address Cr 51b N0160) S4-,t 10M A License# <br /> VIECH S�S,\P, R- - 'sukps <br /> ANICAL COMPANY ,r s <br /> 5IGNATURE REGISTERED VVN I FEE CURREN V I Y I N <br /> Address F5� DxS r_d- tjeo �,J(2,,6_q License# 1 (_!� CO 33 <br /> )THER COMPANY ly-(o ucb6nalcl <br /> iIGNATURE REGISTERED Y/ N I_- rEECURREI\ YIN <br /> Address +fq- 1_)11 License# 1 cc <br /> III I'll 14-1,141 vil 11-1 111 111 111111111 111111 11111111 <br /> ZESIDENTIAL 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&I dumpster;Site Work Permit for subdivisions/large projects <br /> -OMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page-,(1)set of Energy F&M—S.R-6-W Permit for 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 /> )IGIN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> - - - - - - - - - - - - - - - - - - - - - - <br /> ftections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2600,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 /> IVER THE COUNTER PERMITTING (copy of contract required) <br /> woofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />