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°"-,OU-'�'�� c:iry ot�ephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin _ <br /> i <br /> Owners Name /' Owner Phone Number � �>(��� <br /> Owner's Address � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number �— <br /> Fee 3lmple Tltleholder Address <br /> JOB ADDRESS ` � LOT* C� <br /> SUBDIVISION PARCEL ID� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED B NEW CONSTR 8 ADD/ALT � SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> � <br /> DESCRIPTION OF WORK ' <br /> BUILDIN(3 SIZE SQ FOOTAGE HEIGHT '�' <br /> QBUILDING S .._ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL S �>� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a � � <br /> QMECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION � �� � <br /> OGAS Q ROOFING Q SPECIALTY C] 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 �f'� <br /> SIGNATURE REG�STERED Y/ FEE CURRE� Y/N <br /> Address License# r����� � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address Ucense# <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 /> Addrosa License# � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bultding Plans;(1)set of Energy Forms;R-O-W Permit for new constructlon, <br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadBHes d�1 dumpster;Sfte Work Permlt for subdivlsionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Bulldl�g Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minlmum ten(10)wo�lcing days after submlttal date. Required onsite,Construcrion Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliHes�1 dumpster.Site Work Permlt for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY requlred for all NEW construcdon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Co�tractor sign back of applicadon,notarized <br /> If over i2S00,a Notice of Commencement Is roqulred. (A/C upg►ades over t7500) <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 AppllcaUon Only) <br /> Reroofs ii shingles Sewers Servlce Upgrades A/C Fences(Plof/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />