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a��-�eo-oozo City of Z phyrhills Permit Application Fax-e»-�aaoozi <br />' Building Departrnent <br /> Date Recefved Phone C ntact for Pertnitting W �S� <br /> Owners Name W�) � . [1�f p �,L Owner Phone Number �j 3'' -i � ' ,/.. � <br /> Owners Address .�1 •�� � �.L +�{' y0�p�er Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3 � . � � �7J LOT# I � <br /> SUBDIVISION �� Y �� PARCEL I Dl� ' 'O�3 l�� _l�" OI <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSfR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE _Q SFR Q COMM 0 OTHER * <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK li O '�' {... �[. �� �7 /� �+(�1�� ��p J <br /> 1 <br /> BUILDING SIZE SQ FOOTAGE HEIGHT � <br /> �-)� G--�y��� <br /> QBUILDING S V UATIONOFTOTALCONSTRUCTION ����� � ,� � <br /> QELECTRICAL $ AM SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �a`�� <br /> QMECHANICAL $���!O O V UATION OF MECHANICAL INSTALLATION � , <br /> QGAS � ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERm Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE rtECis�rtEO Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N �e cuRREn Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE �cls�teo Y/ N F�cuaaen Y/N <br /> Address License# <br /> OTHER � COMPANY � � � �S - <br /> SIGNATURE REGISTErtm Y/ N FEE CURRE� Y/N <br /> Address •�. c7 d� � �>,`�3$ay License# � <br /> 1 F 1 1 1 1 1 1 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 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t 1 1 1 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PI ns;(1)set of Energy Fortns;R-O-W Pertnk far new construdion, <br /> Minimum ten(10)working days after subm' I date. Required onsite,Construction Plans,Startnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work ermit for subdivislons/large projects <br /> COMMERCIAL Attach(3)camplete sels of Building Plans p s a Life Safety Page;(1)set of Energy Fortns.R-O-W Pertnit far new consWction. <br /> Minimum ten(10)working days after submi I date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 81 dumpster Sile Work ermit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requlred for all N W cansVuction. <br /> Directions: <br /> Fill out applica6on completely <br /> Owner 8 ConVactor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$7500) <br /> " Agent(for the conVactor)a Power of Attomey(for the er)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicati Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter ff on public roadways..needs ROW <br />