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813-780-0020 City ot �ephyrhills Nermit Application �� � tax-�l3-inU-UU11 <br /> • � Building Department <br /> Date Received phone Contact for Permittin — <br /> '�Owner's Name �� a�412 � � ���1 �1►1� � ����� Owner Phone Number � ��� — � O �J `5 <br /> � Owner's Address 3 �� u� (� �U� Owner Phone Number �_ � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> � JOB ADDRESS ����I � S � ' ( � � � r�� � ,S LOT # � <br /> SUBDIVISION �— . PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> �WORK PROPOSED e NEW CONSTR 8 ADD/ALT Q SIGN �] Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> �fDESCRIPTION OF WORK (� ���� F S�1 � r1 -� re S <br /> BUILDING SIZE SQ FOOTAGE � HEIGHT <br /> �"� QBUILDING $;�/ L, �Q VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY W.R.E.C. <br /> QPIUMBING $ . � <br /> �� , , <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � / <br /> .� <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER �J /� <br /> ./ <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO J /`✓''� <br /> �BUII,DER � ��� , � �COMPANY �V(� QS�O�� �uYLY�£ �Yl �jQ j ' <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 <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> RESIDENTIAI. Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construcdon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Woric Permit for subdivisions/large proJects <br />