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�• - aia-�ao-oo2a City of 2ephyrhills Permit Appiication Fax-813-780-q021 <br /> Buiiding E}epartmen! <br /> _ .,„.'"-`-'" 4�'- <br /> , �� Date Received �^- T ,° ~� <br /> ��� Phone Contad for PermiKln� �� <br /> � � � tie � � '. -i � • • ..LS� r � � � rrr.t�' . <br /> Owner's Name � T� Own Phone NUmber ��3"`10�c"" d <br /> Owner's fuidress � . 3 J�t Owner Phane u�F!'m6er��M �V�'"�'T'i� <br /> Pee Simple Titleholder Name �� � Owner Phone Number �_--y_..-� <br /> Fee Simple 7ltleholder Address <br /> JQBADORESS �� r Y. 1itt�tS �i. 3��I l0T# d� <br /> 5�,��►,�S�oN oak Q un '� P������ 34- aS-a1-(��oa-o000 0-o�.3 0 <br /> (�Tt�EED FRON PROPERTY TA7C NOTiCE} <br /> WORK PROPOSED e NEW CoN5TR 8 ADD/ALT � SIGN C] Q DEMOUSH <br /> INSTALL REPAIC2 <br /> PROR6SEDt,lSE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCI'ION Q 9LOCK Q FRAME � STEEL Q <br /> DESCRIPTIQNOFWQRK tI�IST{R�t�T�GY� UT Q Oi{} YUAt7 SO��tI� N��� �L�XI <br /> BUIlD3NG SIZE SQ�..�_�-GE NEIGMT ��� y���f <br /> ' � .1 <br /> OBUILDING � R � VAI.UATiON OF TO?Al STRUCTION <br /> DELECTR�C L $ AMP SERVICE PROGRESS ENERGY Q W.R.E.C. �^� <br /> V <br /> �PLUMSlIV �;�� <br /> � L �..- <br /> OMECHANIG� L �� VALUATI OF MECHANICAL INSTALLATION �, �i�+ <br /> . i <br /> QGAS Q ROOFING 'SPECIALTY �� OTHER ��'1 � <br /> � �� <br /> FINiSHED Fi.00R ELEVATIO F�OpC}ZOhtE AREA QYES NO � ' � <br /> � <br /> BUl�DER � � COMPANY � � ��� <br /> S16NATURE REGISTERED Y/ N FEE CURftEA Y/N <br /> A+ddress �icense# � � <br /> ELECTRICIAN �- � C4MPANY �-- � <br /> 516NATURE � REGISTERED Y I N FEE CURREM1 Y 1 M s <br /> Address �icense�t �^�� <br /> PIUMBER � � COMPANY � <br /> SIGNATURE � REGISTERED Y/ N FEE CURi2E� Y/N <br /> Address �icense# � � <br /> MECHANICAI. � COMPANY � <br /> SIGNATURE REGISTERfD Y I N FEE CURRER Y I IV <br /> Address �_ _�/( j � License# � � <br /> �- �� <br /> ����� OTHER � �COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �ieense# � <br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 M 1 1 1 1 M 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <br /> RESIOENTIAL Attach(2)Pbt Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Mlnimum ten(i 0}working days after submittal date. Required o�site,Construction Ptans,Stortnwatsr F+lans wt Silt Fence installed, <br /> Sanitary Facitities&1 dumpster,Site Work Permit for subdivisionsAarge prp}ects <br /> COMMERCIAL Attach(3)complete sets pf Building Plans plus a Life Safery Page;(1)set of Energy Farms.R-O-W Permit tor new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Pfans,Stormwater P1ans w/Sift Fe�ce installed, <br /> 3anitary Facllities&1 dumpster Site Wwic Permit for a8 new pro�ects.AII commercial requirements must meet compiiance <br /> SiGN PERMIT Attaoh(2}sets of Engineered Pians. <br /> ""PROPERTY SURVEY required far all NEW constructlon. <br /> Directions:• <br /> Fili out spplication completely. <br /> Owner 8 Contractor sign baak of applicaGon,notarized <br /> If over S250Q a Notice of Commencement Is requEred. (R1C upgrades over 57500} <br /> " Agent(for the condactor}or Power of Attomey(for the owner)would be someone vnth notarized ietter from owrrer authonzing same <br /> OVER THE CpUNTER PERMITTING (Front of Application Qnly) <br /> Reropfs if shingies Sewers Service Upgrades NC �ences(PIoUSurveylFootage) <br /> priveways-Not over Counter if on puWio roadways..needs ROW <br />