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uny of"Gephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> Date Received 5l�q�tG�ltxin� ('hb+ �i1•C�� <br /> Phone Contact for Permitting — <br /> Owner's Name Owner Phone Number q� <br /> Owner's Address +J►" 33 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS Z 5 �'V '3 3 LOT# �1 <br /> SUBDIVISION" ��r ��ARCEL ID# S'- -0( 0 -oU L ` Go p <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN 0 0 DEMOLISH <br /> E� INSTALL E REPAIR <br /> PROPOSED USE SFR 0 COMM L� OTHER <br /> TYPE OF CONSTRUCTION E:2- BLOCK Q FRAME STEEL 0 r,� <br /> DESCRIPTION OF WORK 5;iA V - a S <br /> BUILDING SIZE SQ FOOTAGE iPi � HEIGHT <br /> I all fly M­r­ <br /> "BU.ILDING 0 <br /> `0,� VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ w U AMP SERVICE 0 PROGRESS ENERGY W.R,E.C. <br /> l� -1 <br /> =PLUMBING $ <br /> =MECHANICAL $ ,j VALUATION:OF.MECHANiCAL INSTALLATION <br /> =GAS "( ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS . r FLOOD ZONE AREA =YES NO <br /> +o <br /> BUILDER ft COMPANY C= <br /> SIGNATURE l-� REGISTERED Y/ N FEE CURREN Y/N <br /> Address ., License# ( bra .DTI <br /> =_LECTIZICIAN,, COMPANY <br /> SIGNATURE REGISTERED / N' FEE CURREN J Y/N I <br /> tt <br /> Address 3 License# G o cl sa t�� <br /> SLUMBER COMPANY 1�J Jtnt'R <br /> 3IGNATURE REGISTERED Y/ N FEE URREN /N <br /> Address G 3f a .�Ab�C' h � ��.f S'-Q. l0ot) �{a� 3 a{ t License# CF <br /> MECHANICAL _ COMPANY +f S <br /> iIGNATURE REGISTERED VVN , FEE CURREN Y i N <br /> Address J U License# CA ccs n' w <br /> OTHER COMPANY r U rl� CSt`i <br /> SIGNATURE REGISTERED Y/ N I FEE CURREN Y/N <br /> Address [, .� t'o License# cc <br /> III.IIIIlII.IIIIiIIIiiIillill"1I � 1tllllll" IIIIIIIIIIIIIIIIIiIIIiiiI.iilll <br /> tESIDENTIAL 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/Siit Fence installed, <br /> Sanitary Facilities&1 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 Forms.R-d-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 all new projects.All commercial requirements must meet compliance <br /> iiGN PERMIT Attach(2)sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> )Irections: <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 Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> IVER THE COUNTER PERMITTING (copy of contract required) <br /> ;eroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />