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813-780-0020 City ot �ephyrhills Nermit Appucation ,, � rax-tsis-iuu-uuz� <br /> Building Department � 1 /SSS � � <br /> lt � - <br /> Date Received �'2 2�� I Phone Contact for Permittin �s � — � 3� C �� f � <br /> �I' Owner's Name ,�N� /u � �U/e (J L Owner Phone Number a � � ��� � `��� <br /> � Owner's Address d�a� uAKFiQ �/�C7t s� Owner Phone Number �� <br /> 335µa-� <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> Fee Simple Titleholder Address <br /> � JOB ADDRESS � L/ t��2 /��� 4 L� 5 � LOT # �� <br /> �+SUBDIVISION //��T��i/C �J'•Qf/� p7�ARCEL ID# � 2 � v�� � ` �� � O� � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> �WORK PROPOSED NEW CONS7R� ADD/ALT � SIGN Q Q DEMOLISN <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> `�' DESCRIPTION OF WORK ��✓j%�-C-i/Ur ' IOJ� /� dS.��D' , <br /> C1 <br /> BWLDINGSIZE � ����� � SQFOOTAGE r �v HEIGHT <br /> QBUILDING $�� ��� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> � UILDER - _ � � COMPANY �Ul/rll7� <br /> GNATURE � REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <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, Constructlon Plans, Stormwater Plans w/ Silt Fence Installed, <br /> Sanitary Facilities & 1 dumpster; Site Wohc Permit for subdivislons/large projects <br />