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s��-�ao-oo2o City of phyrhills Permit Appiication Fax-81&780-0021 <br /> � Building Departrnent <br /> Date Recelved Phone oMactfor PertnHfin <br /> Owner's Name Owner Phone Number ��� � � <br /> Owner's Address ��J }' Owner Phone Number <br /> Fee 3lmple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � � LOT# � <br /> SUBDIVISION PARCELID# �I' �'O� -D �D <br /> (OBTAINED FROFA PROPERTY TAX NOi10E) <br /> WORK PROPOSED e NEW CoN57R e ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCWPTION OF WORK • ' T� <br /> BUILDING SIZE SQ FOOTAG l � L HEIGHT G� <br /> QBUILDING $ O V UATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ A P SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ `���� <br /> OMECHANICAL $ V LUATION OF MECHANICAL INSTAUATION � ` <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE r�Gls'reReo Y! N �CuHaQ. Y I N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N F�CuartEn Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE r�cisrEa�n Y! N �ecuruien Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTErte� Y/N FEE CURREA Y/N <br /> Addreas Lfcense# <br /> /�� � <br /> OTHER COMPANY (! <br /> SIGNATURE REGISTERED Y/ � uRrtEn Y/N <br /> Address G Q ��,�(r License# <br /> IIIIIIIIIIIIIIIIIItlllllllll 111 11 IIIIItlllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PI ns;(1)set of Energy Forms;R-O-W Permtt for new construction, <br /> Minimum ten(10)working days after subm' I date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Faciiities&1 dumpster,Site Work ermit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)camplete sets of Building Plans us a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructian. <br /> Minimum ten(10)working days after su6m' I date. Required onsite,Conslruction Plans,Stortnwater Plans w!Silt Fence installed, <br /> Sanitary Facil'�ies&1 dumpster.Sfle Work ermit for all new projecLs.M commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all N W consWction. <br /> Dlredlons: <br /> Fill out applicatian campletely. <br /> Owner&Contractor sign back of applicadon,notarized <br /> If over 5z500,a NoUce of Commencement is required. (A!C upgrades over 57500) <br /> " Agent(far the conVactor)or Power of Attomey(for the o er)would be someane with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITi1NG (Front of Applicati n On�y) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage) <br /> Drlveways-Not ovar Counter If on public roadways..need ROW <br />