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°"-'n`�""`u c:iry ot[ephyrhills Permit Application Fax-813-780-0021 <br /> ' Building Department <br /> � � <br /> Date Received � - �/ <br /> Phone Contact for Permittin <br /> Owner's Name � .���� JC�� Owner Phone Number <br /> O�nrner's Addresa ���5 � ,L�,�Y)�,;�� %�1' p�er Phone IMumber �� 3- � ,. � <br /> Fee Simple Titleholder Name —� <br /> Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��O S � �� � N D) �I S l.�j� �� <br /> LOT# <br /> SUBDNISION PARCEL IDN <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1MORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN [�] Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [� SFR �] COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �� STEEL [� <br /> DESCRIPTION OF WORK S r� h •��„ l�e - �� <br /> BUILDING SIZE I.���J Sq FOOTAGE �.�� HEIGHT �J � <br /> ILDING <br /> a ��� �� °= VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGF�SS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � �/� <br /> �� �/ <br /> QMECHANICAL a VALUATION OF MECHANICAL INSTAL TIO� <br /> QGAS Q ROOFING Q SPECIALTY C� OTHER '�/� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES NO <br /> BUILDER �. COMPANY �������I� I'�`J�'� ��(��S <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ���� ���� N Q C,j l� � License# <br /> � C. C� I 3��'��9 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP 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 /> Addreas License# � � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new consUuction, <br /> Minimum ten(10)worlcing days aRer submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster;Site Work Permft for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safely Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)w�o►king days after submittal date. Required onsite,Conshuction Plans,Sto►mwater Plans w/Silt Fence installed, <br /> Sanitary Faciflties 8�1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY requlred tor all NEW construcUon. <br /> Directlons: <br /> Fill out application comptetely. <br /> Ovmer&Contractor sign back of application,notarized <br /> If over SZ500,a Notice of Commencement is required. (AIC upgrades over E7500) <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 Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..needs F�OW <br />