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s�s-78o-002o City ot [ephyrhills Nermit Appucation rax-uia-iau-uuzi <br /> Building Department <br /> Date Recelved Phone Contact for Permlttin -- <br /> Owner's Name �/=J ► `�`-�s ���► �-� i � � Owner Phone Number � 3 ^ � " �- /� / 6 <br /> Owne�'s Address 3 ��� �/ Gi� Ce /� tf Owner Phone Number �• � <br /> Fee Simple Titleholder Name � Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �U ` S �"t ' �� �— �" v LOT # � <br /> SUBDIVISION kr����s �� ��ARCEL ID# Y�v al �'(,GG�� "�ZO � QOUQ <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEw CONSTR e ADD/ALT Q SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK !J �-r`ti-tt O�7' � � ��L <br /> BUILDING SI2E S 7�� SQ FOOTAGE -��°� • HEIGHT <br /> OBUILDING $ � �/'0 VALUATION OF TOTAL CONSTRUCTION <br /> �J i <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� r��q� <br /> � <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE 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 Ucense # �— <br /> OTHER . COMPANY C � s I��' j' (� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' �• �� < < �d�Q,c � 'l�� <br /> License # <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permlt for new consUuction,. <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Wo�ic Permit for subdivisionsllarae orofects <br />