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• e'3-�so-°°Z° City of 2ephyrhills Permit Appiication FaX a�a-�saoozi <br /> BuiMin9 p�pertm�t <br /> Date Reeeived � �� <br /> -i T-� Plwne CaMSCt tor Pwmtitfin <br /> � �ersName � r Ow�erPhoneNUrMer ��1�' - <br /> Owner's Addreas �Y � O�rner Phone Nunber <br /> Fee Slmple Titlehdder Name �����N� <br /> Fee Simple Tidehdder Addrcss <br /> ���� h�s . � � � <br /> SUBDIVISION �PARCEL IQA� �' ��� .- � <br /> (OBTANIED FROII PROP6tTV TAY N0710E� <br /> riORK PROPOSED � NEw CONSfR ADDlALT � SIGN Q � DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> TYF'E OF GONSTRUCTION � BLOCK FRAME � STEEL � <br /> DESCRIPTI�I OF WORK D Y � r ��S <br /> BUILqNG SI� SQ FOpTACaE HEIGHT <br /> OBUILDING $ <br /> l S � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PRpGRESS ENERGY Q W,RE.C. <br /> QPLUMBING y <br /> QMECHANICAL $ VALUATION OF hJECHANICAL INSTALLATION <br /> 0� ROOFING a SPECIALTY � OTMER � � ���� <br /> FINISHED FLOOR ELEVATIONS FLOO�ZONE AREA OYES NO �.�'� ���� <br /> BUILOER � C�P� � <br /> SIGNATURE rtErurrert�p Y/ N fEE cuRRen y/N <br /> Address <br /> License# <br /> ELECTRICIAN C�P�Y � <br /> SIGNATURE <br /> ���� Y! N �ctxa�n Y/N <br /> Addross � <br /> License# <br /> PLUYBER � CONP/WY � <br /> SIGNATURE REGISTERED Y/ N FEE cURREF Y/N <br /> Addrcss <br /> Lice�ue il <br /> NECH/WICAL � C�P�Y � <br /> SIGNATURE rtEC,�s7E�u Y/ N <br /> �curx�n Y/N <br /> Address � <br /> License# <br /> OTHER <br /> S�GNATURE C�PµY <br /> �c,isiEaEO Y N �e cur�n Y/N <br /> Address L��# � ^ –1—� <br /> t11t111111111t11111111111111t1111111111111111111111111111111t111111I <br /> RESIDENiIAL qttach(2j Plot Plans:(21 sets of Building py,�;(�)�t a(Energy Forms:R-aW Pertnit for new construdion, <br /> Minimum ten(10)rqrking days after subrnittal�te. Requaed onsite,Consiruaion pl�s,Stormyreter Wans w/Sd[Fe�e installed, <br /> Sanitary Facili0es g 1 dumpster,Site Wak Permit for r,ubdivisi�n��ye prajecLs <br /> COMNERCIAL ,qt►ach(3�cq�p�e sets d Buildi pa� <br /> ^9 plus a Li(e Safery Page;(1)set of Energy Forms.R-aW Permk for nctiv construction. <br /> Minimum ten(tp)workoiy day5 after SubrMtlal data <br /> Sanitary Faalities&1 dum ���°�.�S�UO^�^$�Stamwater Plans w/Si[Fenc�insfalled, <br /> SIGN PERYIT Attach 2 sWS of E �g'Site Work Permi(for aN new projeds.AII oommg�al req���yS must meet compiance <br /> � ) ^9�U�d Plans. <br /> ""PROPERTY SURVEY req�ured for aY NEW conspu�tion. <br /> Directio�� <br /> Fi1 out applimtion complety�y, <br /> Oumer&CanUaclor sign b,xk of app6catlon,nptarize� <br /> H over 52500,a Notice�Cammenennent b►equlred. (AfC upgradea over 57500) <br /> " Agenl(for the contracta)or Power of Attomey(tor tl�e owner)would pe some�ne wilh notanzed letter from awr�autlpri��y�me <br /> OVER THE COUNTER PERNITl7NG (FroM a/qpppqy�pryy� <br /> •°.er�ois it shingles Sewers Service Upgades A/C Fences(PbUSurvey/Foutege) <br /> DNveways-Not over Cour�ter ff on publi��o�dyv�ys__needs ROW <br />