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� ' - <br /> s�s-7ao-oozo ,,5��' City ot�ephyrhills Nermit App�ication rax-tsis-itsu-uuz� <br /> Building Department , <br /> Date Recefved � � l-�' phone Contact for Permittin - <br /> Owner's Name �i�-C�-7� Owner Phone Number O �����O? �� <br /> Owner's Address 7�J�+ 1��� Owner Phone Number <br /> Fee Slmple Titleholder Name � Owner Phone Numbar <br /> Fee Simpte Titleholder Address <br /> JOB ADDRESS � /D? �J � til°'��� �� �31"�- LOT# [� <br /> SUBDIVISION S�� , PARCEL ID# a oC�' b'- ��CJ��o��+d�Sv <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONS'F ADD/ALT SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK ///�-� �L �/� NZ�� NG�. <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ , � <br /> ,. 1��� <br /> �iuIECHANICAL $ VALUATION OF MECHANICAL INSTALLA ION <br /> QGAS Q ROOFING Q SPECIALTY 0 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 v� COMPANY �N�� „!� ��r-v� <br /> SIGNATURE REGISTERED N FEE CURREA Y/N <br /> Address � � G�-�. ���,�i� f/ 3.�n"r— License# ��?- ��� <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# �— <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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 installed, <br /> Sanitary Facilities&1 dumpster;Site Wortc Permit for subdivlsions/large proJects <br /> COMMERCIAL Attach(3)complete sets of Building 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.Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet wmpliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""*PROPERTY SURVEY required for all NEW constructlon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Confractor sign back of applicaUon,notarized <br /> If over;2500,a Notice of Commencement is required. (A!C upgrades over;7500) <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 , jFront of ApplicaGon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />