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-- ---- UIty Or Gephyrhills Permif.Appllcation Fax-813-780-0021 <br /> Building Department'` <br /> Date Received Phone Contact for Permitting C�Sb eG Ch QiQ & ._ k-k0rft0, COM <br /> Owner's Name t Owner Phone Number 1_� 7 <br /> Owner's Address I e hr / 043t/ Owner Phone Number <br /> Fee Simple Titleholder Name Owner phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# r <br /> SUBDIVISION 1 �j��-nd� PARCELiD# b L 60 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN 0 DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE SFR COMM L i OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME STEEL Q <br /> DESCRIPTION OF WORK 1v S1S <br /> BUILDING SIZE SO FOOTAGE � � HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> a oob <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING �$ <br /> =MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING = ' SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER p'( /~ r�,.r���~ COMPANY ; <br /> SIGNATURE 4.°® REGISTERED Y/ N FEft CURRER Y/N <br /> Address 12 0 �_ License# [Cs Ca mt)6 <br /> ELECTRiC1AN r _ a/� COMPANY . <br /> SIGNATURE "�'�"s' REGISTERED Y/ N FEE CURRER I Y 7N ^^�y <br /> Address ,r License# C��i d(�3T�� <br /> PLUMBER COMPANY in <br /> SIGNATURE �'"� REGISTERED Y/ N FEE CURB N Y/N <br /> Address 73nv RM 33617-- License# C <br /> MECHANICAL COMPANY IY55 ivy if'�1 r <br /> SIGNATURE ✓� REGISTERED /'N FEE CURREN Y/N <br /> Address 5- 7 1�e+r' C� License# ti.� 33 " i ~� <br /> OTHER j Jj � COMPANY mc—amia <br /> SIGNATURE tt tddj (,�'�� REGISTERED Y/ K FEE CURRER i Y/N <br /> Address 'r 3 License# i 2 5--3}3 <br /> 1111111111111 Kill 1i1,111N11111iiI111111111111111111111111111111111•ii <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(1b)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 Farms.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 /> It over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> i" 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 (copy of contract required) <br /> Reroofs if shingles Sewers' Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />