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s�s-�saooza City of 2ephyrhills Permit Applicatian f�x-813-780-t3021 <br /> Building Department <br /> Date Received � phone Contact for Permittin -- <br /> Owner's Name t���� Owner Phone Number <br /> �+�����i�2.. <br /> Owner's Address �er Phone Number �- � <br /> Fee Simpie Titiehaider Name �� � Owner Phone Number �� � <br /> Fee 3imple 1'itieholder Add�ess <br /> .tOB ADDRESS L�'' Gt, �i� LOT� C^� <br /> SUSDIVISION PAttCEL IL1# <br /> (08TAINED FROM PRdPERT1(TAX NOTICE) <br /> WORIt PROPOSED e NEw CONSTR 8 ADDIALT [,� SIGN Q Q DEMOIiSH <br /> INSTAI.L REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTNER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTiON OF WiJRK � � J�`L(Z�{J ' � w <br /> 8lTIL.DING SIZE �_ � SQ FOOTAGE 1iE1GHT ��—� a �� �? � • <br /> QBUI�D#NG �> _� ti/AI.UATIORI OF TOTAL CONSTRUCTION <br /> �E�.ECTRlGAL � � AMP SERVICE Q PRdGRESS EIVERGY Q W.R.E.C. <br /> QP�UMBING ��� <br /> .���Z Z- <br /> �MECHANlCAL S rp,,y�,t�7 VA�UATlpN OF MECHANICAL INSTALtATlON <br /> �J tJy'�✓ ���(_ <br /> QGAS Q ROQFING Q SPEGIALTY � OTHER �� <br /> FINISHED FLOOR ELEVATIONS �� � FLOOD ZONE AREA QYES Np <br /> BUILOER Ct7AlIPANY <br /> SIGNATURE _ R��i5rEttEO Y/ N FEE CURRE� Y!N <br /> Address �icense# � � <br /> ��ECrr:�c��st � con��Aenr Ql4 tl 1 a � R <br /> SIGNATURE � aEGisreR�o Y/ N FEE RRE� Y/N <br /> Address �J� G`{ �l� � Z" i 1�S� � ,G� �icense# �—��� <br /> PIUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address l.icense# �i � <br /> MECNANICAI. . � � COMPANY � 1%��'�{,�^. • <br /> SIGNATURE ,,, REGISTEREO / N FEE CURRE� Y/N <br /> ad���s �' o.�s'r� Rd ����5�# .�t c t St� 7&9 � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address lacense# �� ^1 <br /> RES10EN71A,t. Attach{2}Piot Plans;{2)sets of Buikfing Pians;{1}set of Energy Forrns,R-O•W Permit for new construction, <br /> Minimum ten(10)woricing days after submittal date. Ftequired onsite,Construction Plans,Stormwater Pians w/Sitt Fence insta)ted, <br /> Sanitary Fadlities&1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3}camplete sets af Buiidtng Plans pius a Life Safety Page;(1)set of Energy Farms.i2-O-W Permit far new cortstructfon. <br /> Minimum ten(1Q)working days after submittai date. Required onsite,Construction Pians,Stormvrater Pians w/Siit Fence instailed, <br /> Sanitary FaciOties 8 1 dumpster.Site Work Permit for all new projects.All commercial requirement&must meet compliance <br /> S1GN PERMIT Attach(2}sets of Engineered Ptans. <br /> «.«.PRqPERTY SURVEY required for all NEW construcUpn. <br /> DireCtiotts: <br /> Fill out applicatlon completely. <br /> t�vmer 8 Contractor sign back af application,notartzed <br /> If over�25�,a�lotice o#Cammencement is requlred. {A!C up�yrades aver ST500} <br /> " Agent(for the conUactor)or Pawer of Attomey(for the owner)would be someone with notarized letter from owner�uthorizing same <br /> OVER TNE COUNTER PERMITTIN� {Front of Applica�on Qnly} <br /> Reroofs if shingles Sewers Service Upgrades A/C Ferrces(Plot/Survey/Footage) <br /> D�{veways-Not aver Counter if on pubiic roadways..needs ROW <br />