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o is-iou-wtu c;ity ot�ephyrhills Permit Application Fax-813-760-0021 <br /> � Building Department <br /> Date Received � 'J <br /> ` �''` ` Phone Contact for Permittin <br /> Owner's Name /j ' �iss� ,�7 -' j��( �� -- �p/� <br /> ner hone Number -�3"�tJ V " �C, <br /> � i � /,��,�,,�s ct..-- <br /> Owner'sAddress c,�J�� �'r'phone Number ��� ��— Z�Q <br /> Fee Simple Titleholder Name �. Owner Phone Number <br /> Fee Simple Titleholder Addreas <br /> JOB ADDRESS '1j�� vL � �� <br /> LOT� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM pROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT [—� SIGN Q O DEMOLISH <br /> iNSTALL REPAIR <br /> PROPOSED USE Q SFR [� COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK �] FRAME [—� STEEL [� ----� <br /> DESCRIPTION OF WORK i/ � �� � �rj'!�' ,� �7��-- <br /> BUILDIN(3 SIZE SQ F�OTAGE� HEI(3HT C—_� <br /> QBUILDING a <br /> , VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ y �,�?o �:_ AMP SERVICE � PROGRESS ENERGY [� W.R.E.0 <br /> /-' ~'' , [J <br /> QPLUMBING a � /� �,����� <br /> l r/�/ `l��°�j'" c>�! .� ,�'� T( , "`�'.x-'�_-/, <br /> �1 � <br /> OMECHANICAL � VALUATION OF MECHANICAL INSTA,j.b4Tl N C� j � ,,�.��/y'�— <br /> �j�j v �� <br /> OGAS Q ROOFING Q SPECIALTY � OT ER ��� � ��� �, <br /> ,?�' �-�� <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA S O i <br /> �; <br /> BUILDER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � �—� <br /> ELECTRICIAN �'� � /� COMPANY �VCA ��r_�c'T��C �L�' <br /> SIGNATURE <.v l '� 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 /> MIECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REC,ISTERED Y/ N FEE CURRE� Y/N <br /> Addross License# <br /> RESIDENTIAL Attach(2)Plot Pians;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new conshuction, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Co�sUuction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary FadBtles d�1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Perm(t for new construction. <br /> Minimum ten(10)working days after submittal date. Requtred onsite,Conshucrion Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadliUes 8 1 dumpster.Site Work Permit for all new projects.Ail commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requlred for all NEW construcdon. <br /> Directiona: <br /> Fill out appUcatlon completely. <br /> Owner 8 Contractor sign back of applicadon,notarized <br /> I(over i2300,a NoNce oi Commencement is roquired. (AIC upgradas over=7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)w�ould be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppllcaUon Only) <br /> Reroois if shingles Sewers Servfce Upgr�des•�A/C •.°f'e�ces(PlodSurvey/Footage) • ., _ , <br /> Driveways-Not over Counter if on public roadways..needs�W� . ` <br /> . .. ...�.r <br />