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� � � � :s - !�v - ooz� <br /> '�� ,_- •7 " 81378D-0020 City of ephyrhills Permit Application Fax'813'�80-0D2� <br /> �., Bullding Depar4nant <br /> 'n�� F, � <br /> +', , wt.R�n�.a �r ��O/S� , Ph Contaet for Permfttln �f 3 ���7 — 9 L1�i Z . <br /> '� 2c�O�o.� -�/�� <br /> p��r��� �u l.�J� J O��SO I Owner Phone Numbv <br /> o�.r:�da� 3��a 3 ���c�� p � A�� p�y�er Phone Numb�r <br /> Fn Slmpl�TWeholde Name I Owner Phone Number <br /> I <br /> FN Simpb 7Nlehold� Address I <br /> JOB ADDRE93 , o�o��J �Ll C'_Q_1 �lRl S � (L LOT! � <br /> SUBDMSION Y�l't'"�l,�O�r � PARCEL I� �L��J'Z l� 00?7 0 �DOOO[JO'O(2L7 <br /> �osruNm Fnor vieoa�rsrr r�x HaneE7 <br />' WORK'PROPOSED NEW CoNSTR ADD/ALT �] SIGN Q Q DEMOLISH <br /> B INSTALL B REPAIR ' <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRU ON Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF W RK 1"� 1 C C� � �•S /D tJ �3 S.�C'/L � P <br /> BUILDINO SIZE SQ FOOT E CI] HEIQHT � <br /> QBUILDING S V UATION OF TOTAL CONSTRUCTION � <br /> OELECTRIC S P SERVICFJ Q ' PROGRESS ENERGY Q W.R.E.C. <br />, QPLUMBING S <br />, <br /> �MECHANIC � J_ � UATION OF MECHANICAL INSTALLATION <br /> lQ <br /> QGA$ Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR EL ATIOPIS FLOOD 2i NE AREA QYES NO <br /> I <br /> BUILDER COMPANY <br /> g�G��� 'REGISTERFD Y/N ��� Y!N <br /> �dare.� � u�� <br /> � � <br /> ELECTWCIAN CONPANY <br /> g�G�7�� REGI97ERE0 Y/ N FEE CURRB� Y!N <br /> Ada�es. � uce�se# � <br /> � <br /> PLUMBER C�P� <br /> g�0�7�� �REGISTERED Y/ N �cuRttEr Y I N <br /> Addrps I Lkense# <br /> MECNANICAL �� S�'� COMPAN1f � J'e��f C e S <br /> � g�p��� REGSTERm Y/N �cu�B. Y/N <br /> Addrou �l� �-'v�t'� Y� I ucense# � � <br /> � <br /> OTHER. COMP/WY <br /> SIGNATURE �ciStEREO Y/N FEE CUwta Y/N <br /> Addras I Lleense# <br /> rt r��>> r r n i rr� � r-r�-r rr T rr_r 7 I 1 f f"7�n� r �-� rr-� rr� r1 rr� �r�i-r�n�rn �r rr� I <br /> RESIDENi1AL ch(2)Piot Plans;(2)seffi of Building ans;(1)set oT Energy Fartns;R-O-W Pertnk for new construedon, I <br /> Inimum ten(10)wwidn8 daye ettersu dafe. Requlred amfte,Conatructlon Plens,Starmwater Plans w!Silt Fence Inatalled, <br /> nlfary Fediides 31 dumpster,Site W Pertnft for subdfvls(onsllarge proJecb <br /> � COMMERCIAL (3)complete aeta o1 Buildfng Plens 'ua e Life Setety Pege;(1)set af Energy Fortna.R-O-W Pertnft for new mnstruetlon. <br /> Infmum ten(10)worldng deys after su dete. Requlred ansite,ConaW etlai Plens,Stormwater Piana w/Silt Fence Instelled, <br /> kery Fac�itlas 81 dumpster.Ske W Pertnk for alll new proJeds.All commerdal requiremanfs must meet canpitance <br /> SIGN PERMR eh(2)sets af Engineerod Plana. <br /> PROPERIY SURVEY required for ell EW eonsWdion. <br /> Dlnetlom: � <br /> FlII aRapplica8 completay. , <br /> Owner 3 etor aign beck of applica8on,notarizer <br /> M over:2500, Notlu of CommenumeM is requi . (MC upgredes over i7500) <br /> " Agent(for the Vactw)or Powaz af Attomey(for the o er)would�someone with notarized letter from owner euthormng same <br /> OVER THE COU R PERMR7IN(i (Front of Appll on Onty) I � <br /> Reroofs if ehingles ' Sewers SeMee Upgradea Al Fences{PIoUSurvey/Footage) <br /> Drlveways-No over Courrter if on publfe roadways..n ROW <br /> , <br />