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a�a-�ao-oo2o City of ephyrhills Permit Application Fax-813-780-0021 <br /> Building Departrnent <br /> 1 Date Recelved � � Phon CoMaet for Pertnittin ( L — 2 d� <br /> OwnersName 'JD � ��1�� •i�V`C - 'iv�� OwnerPhoneNumber �f�� ��C� <br /> Owner's Address 3� �• 9✓Q� � "�t�7 � Owner Phone Number <br /> Fee Simple T(tleholder Name �OSC I N►e -f+v ir� Owner Phone Number <br /> Fee Simple TiGehalder Address 3 35S � 2, ��G��� �ll}� � �3�� <br /> JOB ADDRESS � D ��/ J� ° � � /] � . � ��!�` LOT# � <br /> SUBDIVISION PARCELIDk �����l D()%D ��5� (/U� <br /> (OBTAINED FROM PROPERTY TAX NOTiCE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM' Q OTHER <br /> i TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK �� �G7 C'e s ��t-^ I � <br />�I BUILDING SIZE SQ FOOTAG � �G � <br /> HEIGHT <br /> OBUILDWG $ V LUATION OF TOTAL CONSTRUCTION �(,��� <br /> i � <br />' QELECTRICAL $ A P SERVICE Q PROGRESS ENERGY Q W.R.E.C. � <br />' �PLUM8ING $�t 37�8 G�V � � ���G�� <br /> � � � <br /> OMECHANICAL $ V LUATION OF MECHANICAL INSTALLATION /�,�7 <br /> � � ��/f����0 <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER "( �/ / �l�`�/ / <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � �/ <br />' BUILDER COMPANY <br /> SIGNATURE �Glsr�o Y/N F�cuaaEn Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE a��isrEa�U Y/ N �FEE GURREA Y/N <br /> I � � � .. • � • <br /> Address License# <br />�, PLUMBER COMPANY ��Z r�� 1 �`3 m�Cr s L�� <br /> SIGNATURE �clsrEam Y/ N F� ur�n Y/N <br /> �9 `"� , <br />� Address � `d l 4v. �(��� e $ 7''J(O( . License# ��L= f Z�. 3 <br /> I <br /> I MECHANICAL COMPANY <br /> SIGNATURE r�cls�o Y/ N- ;�E Cuw�n Y/N <br /> il Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> Illlllllllllllltllllllllllltlllltlllllllllltllllltlllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PI ns;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submi I date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work ermit for subdivisions/large projects <br /> COMMERCIAL Ariach(3)complete sets of Building Plans p us a L'rfe Safety Page;('I)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after subml I date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work ermR for all new projects.All commerciai requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all N W construction. <br /> Dlrectlons: <br /> Fill out application completety. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement Is required. (A!C upgrades over 57500) <br /> '• Agent(for the conVactor)or Power of Attomey'(for the o er)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITf1NG (Front of Applicatlo Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIaVSurvey/Footage) <br /> Drlveways-Not over Counter if on public roadways..needs ROW <br />