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013-/6U-WLU c;iry ot[ephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact tor Permittin / � �a __ � Q l <br /> Owner's Name 2G/Y� ��Q[� D y� tf- /��) pW�er Phone Number 702 -pZ�p "�a j <br /> Owner's Address /8� �� ,�- F�,�j ��pymer Phone Number <br /> Fee Slmple Titlehoider Name Owner Phone Number �— <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS Q � �� <br /> LOT� <br /> SUBDIVISION PARCEL ID* �'1�' - /-Od -Q3 -�/� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR� ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL [] <br /> DESCRIPTION OF WORK /� � (,�J�l�} E'-DL[L `o� �'p7Yj ONe- <br /> BUILDING SIZE SQ FOOTAGEC� HEI(3HT <br /> QBUILDING a <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL s AMP SERVICE Q PR ESS ENERGY Q W.R.E.C. <br /> QPLUMBING a <br /> �� J��U�• <br /> OMECHANICAL S ���� � VALUATION OF MECHANICAL INST LLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> 9UILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Addreas 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 /> , <br /> MECHANICAL ° ~ COMPANY /I/��S !!-/IIG�}S�f��NG <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ���/ �"��P/1� /� `/�J I 3�5LL License# ��ca�3 95�� <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Athach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)wo�icing days after submfttal date. Required onsite,Constructlon Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanftary Fadlftles�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 Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence i�stalled, <br /> Sanitary Facilities S 1 dumpster.Site Work Permit 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 consUuctlon. <br /> Directiona: <br /> Fill out applicatlon completely. <br /> Owner 8 Co�tractor sign back of applicatlon,nolarized <br /> If over S2S00,a Notice of Commencement is requlrod. (AIC upgrades over t7500) <br /> " Agent(for fhe contractor)or Power of Attomey(for the owner)would be someone w(th 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(Plof/Survey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..needs ROW <br />