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813-780-0020 Gity ot �ephyrhills Nermit Application Fax-a�3-�au-ooz� <br /> Building Department <br /> Date Received � �-�( l Phone Contact for Permittin r7 �� +� -� <br /> Owner's Name � �' �r � �- � " � � � � � Owner Phone Number l � �'' � �"C�� <br /> Owners Address � ( l � � ( -� � �''- ��� �� Owner Phone Number �— <br /> Fee Slmple Titleholde� Name � Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � � O � �I ���- L �� / � LOT # � <br /> SUBDIVISION f , .� ��Vl t/� �� b��, PARCEL �# �� ~° ��''� I _O �� O ��� — ��/� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR 8 ADD/ALT 0 SIGN Q Q DEMOLISH . <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK �� ��� �- � �( ��-J� <br /> BUILDING SIZE � X I°� SQ FOOTAGE � HEIGHT <br /> QBUILDING $����' 1 VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL ($ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �_ <br /> QPLUMBING $ � ` <br /> f 7 <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION `� `�� <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> � 7 � ��S <br /> � � � ? X � <br /> BUILDER , COMPANY L..�J�SO�J��`� :Y � <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 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-0-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 Facilitles 8 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Bullding Plans plus a Life Safety Page; (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 inslalled, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commerciai requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> """PROPERTY SURVEY required for all NEW construcllon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Confractor sign back of applicaUon, notarized <br /> If over 52500, a Notice of Commencement is required. (A/C upgrades over 57500) <br /> *' Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />