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<br /> r . �, 873-790-002� City of�ephyrhills Permit Applicatio�-�`"` F�$���aao �
<br /> Building'Departrnent �;
<br /> . Qate+Received Zr'30�� phon Contal tforPertnitting - Z �
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<br /> Owners Name I Owner e Number
<br /> Owners Address �O � r� �S Owner Phone Number
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<br /> - Fee Simple Titleholder Name I I Owner Phone Number
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<br /> Fee Simple TitleholderAddress I
<br /> JOBADDRESS � V 3 r `S �Ci LOT# 1 �
<br /> SUBDIVISION V,��� W � ARCEL ID# .� - 5-a� - o�� °��QD���`� `�
<br /> i (06TAINEDFROMPROVERiYTAXNO7IC�
<br /> WORK PROPOSED NEw cANSTR ' ADD/ALT 0 SIGN Q 0 DEMOLISH
<br /> INSTALL � REPAIR
<br /> PROPOSED USE � SFR Q COMM 0 OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK �,1 r I � rY� � / (,� �Q G�
<br /> BUILDING SIZE SQ FOOTA E I I HEIGHT
<br /> UILDING $• ALUATIION OF TOTAL CONSTRUCTION
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<br /> QELECTRICAL $ P SEIRVICE Q PROGRESS ENERGY Q W.R.E.C. g�R����'
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<br /> OPLUMBING $ j���`v
<br /> ALUATION OF MECHANICAL INSTALIAnON �,,� i��/ � ��
<br /> OMECHANICAL $ �!�� 1 �� �
<br /> �.��j�j� n�,��1:�v '1.�1A/u/�
<br /> QGAS Q ROOFING Q SPECIA ITY Q�OTHER //// l%���_';� er�
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<br /> FINISHED FLOOR ELEVATIONS FL i OD ZONE AREA QYES NO ����� 1 `
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<br /> BUILDER C��P�'
<br /> SIGNATURE �cisTEaEV Y! N FEECURRE� Y/N L�
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<br /> Address I I License#
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<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REC is�RED Y/ N FEE CURRE� Y/N
<br /> Address I I License# /1 A
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<br /> PLUMBER C�IP� � �
<br /> SIGNATURE � r�cis�r�o Y/ N �cuwx�n Y/N
<br /> Address I I License# l:r� �,�
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<br /> MECHANICAL COMPANY
<br /> SIGNATURE i t�cls Y/ N �E cu�n Y/N
<br /> Address License#
<br /> OTHER COMPANY ��� � � ��°����'�
<br /> SIGNATURE ttECisTeReo Y/ N FEE CurtRen Y/N
<br /> Address "( , �J35'T License# `''J ( �`.
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<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building lans;(1)set of Energy Forms;R-O-W Permit for new construction,
<br /> Minimum ten(10)working days after sub ittal date. Required onsite,ConsWction Plans,Stormwater Plans w/Silt Fence installed,
<br /> SanRary Facilities&1 dumpster;Site Wo Pertnit far subdivlsions/large projects
<br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safery Page;(1)set of Energy Fortns.R-O-W Permit for new consWction.
<br /> Minimum ten(10)working days after sub ittal da�e. Required onsite,ConsW ction Plans,Stormwater Plans w/Silt Fence installed,
<br /> 3anftary Facili6es 8 1 dumpster.Site Wo Pertnit for all new projeds.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets af Engineered Plans.
<br /> ""PROPERTY SURVEY required for all EW consWCtion.
<br /> Directions: I
<br /> Fill out application campletely. �
<br /> Owner&CanUactor sign back of application,notatized
<br /> If over 5z500,a Notice of Commencement is require . {A1CI upgrades over 57500)
<br /> " Agent(far the contrador)or Pawer of Attomey(for the er)v,rould be someone with notarrzed letter trom owner authorizing same
<br /> OVER THE COUNTER PERMITTiNG (Front of Applica ion Only)
<br /> Reroofs if shingles Sewers Service Upgrades A/ Fences(PIaUSurvey/Footage)
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<br /> Driveways-Not over Counter'rf on public roadways..nee s ROW
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<br /> Sanita( �acilitp s&1 dum ster,Si�te Wor PPerr�itfor,v~M••VV v•v•v,-vv•V••MV••v•• •p,���v�v����••aac� r�a��a.vi om rc�wc n�ataucu,
<br /> ry p subdivisions/large projects -
<br /> COMMERCIAL Attach 3 com lete�sets of Buildin Plans lus:a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal d te. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed,
<br /> Sanitary Facilities&_1�,dumpster.Site Work Pe it for�all new projects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans. ! j
<br /> ""PROPERTY SURVEY required.for all NEW_ nstniction.
<br /> Directions: i
<br /> Fill out application completely. I
<br /> Owner 8�ConVactor sign back of application,notarized
<br /> If over$2500,a Notice of Commencement is required. (A/ upgirades over$7500)
<br /> " Agent(for the contractor)or Powerof Attomey(for the owner) ould'be.someone with notarized letter from owner authorizing same
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<br /> OVER THE COUNTER PERMITTING (Front of Application O ly) - � - � - • � ' `" - ' " " ' ���
<br /> Reroofs if shingles Sewer§�"--�=��eryice`Upgrad�s�A'/C,`-": endes•(PIoUSurvey/Footage) �_ " " ' ' , , „
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<br /> Driveways-Not over Counter if ori''public.roadways:;neeiis RO ' ., i I ' „ � ,
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