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es�is-iesu-uu�u c;iry ot[ephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Q � Phone Contact for Permittin �/� !�G -- ��f� <br /> Owner's Name .��� � � Owner Phone Number <br /> Ovvner's Address / � S� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �� I G T � LOT# � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAtNED FROM PROPERTY TAX NOTICE) <br /> M/ORK PROPOSED B NEw CONS7R 8 ADD/ALT �� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTIOId Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK /� e /� �//r1 / �(//v1 <br /> BUILDING SIZE �--1 3Q FOOTAtiE HEfGHT <br /> QBUILDING a VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a � �,J %�J�'J /� <br /> '�(i / 15 � � <br /> MECHANICAL $ � � 4 VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � 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 CURREP Y/N <br /> Address License# �- <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � -COMPANY /f/L � l�i�'o ,a�,,-Z co p�s �2 L �" C <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# ��Q /.�p�d � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sats of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construction, <br /> Mfnimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster;Site WoNc Permit for subdivisionsAarge 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 constructfon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Conshucdon 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 compiiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ••'"PROPERTY SURVEY required for all NEW construction. <br /> Directlons: <br /> Fill out application complete�y. <br /> Ovmer&Contractor sign back of applicatlon,notarized <br /> If over 52500,a Notice of Commencement is requlred. {AJC 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 pn pubU�tqa��ivwdys�.needs,ROW <br /> _� <br /> � s <br /> v ,. ..7. <br />