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a�3aeo-ooza City af Z phyrhills Permit Application Fax-813-78Q-Q021 <br /> Buitdi�g Department <br /> m. � <br /> pate Received phane C ntact for Perm[tttng ° <br /> Owner's Name L--aW'k"' !n C-�' �� T�Gr'�','Q`� Owner Phane Number <br /> Owner's Address ��1 � 11�.-� Owner Phone Number <br /> �('-�—�"1�t—��� <br /> Fee Simple Titleholder Name Owner Phone Number �— � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��� ���/���' ~ \N LOT# C� <br /> _ SUBDIVISION _ � � ARCEL Id# —��—��'���— C�CS � __ <br /> ' � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e C1fllAl.7 C� SIGN Q [� DEMOLtSH <br /> INSTALL REPAIR <br /> PROPC}SED tlSE Q SFR Q ; .Qtl���l� [� OTHER <br /> TYPE OF CONSTRUCTION Q BI.00K [� FRAME � STEEI. Q <br /> DESCRIPTION OF WQRK �l C� C.V��•I`} �U � � �G 1�-' � I S <br /> BU(LDING SIZE � � SQ F007AGE HE(GHT <br /> QBUILDING �6 � VAL ATiON OF TOTAL CONSTRUCTION <br /> QELECTRICA�. � � AM S�RVICE � PROGRESS' ERGY W.R.E.C. <br /> ,,..., ._.. ,,..... <br /> [�P�UMBING $ <br /> �7���,[t�tECHANICAI. $ .� ._ � VA� AT10N QF MECNANtCAL INST LATION �ivt..�t�' 1 � <br /> ���� �"' � <br /> QGAS Q ROQFIIVG Q SPECIA�7Y �� OTEf�R -�'�'" <br /> ! <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO " /) r � <br /> L.� � <br /> BUtLpER � COMPANY <br /> SIGNATURE REGIS7ERED Y/ N FEE CURREA Y/N <br /> Address License# � � <br /> ELEC1RiC1AN ^ � COMPANY <br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N <br /> Address License# �� � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � � <br /> MECNANlCAI. CUMPANY ��'CZ TEC� � �; �� S <br /> SIGNATURE REGISTEREQ Y/ N FEE CURRE� Y/N <br /> Address �'�•�o�C ��o� License# ��G� � `t��"�J��p � <br /> OTHEit COMPAFtY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# �� � <br /> RESIDENTIA� Attach{2}Plot Plans;{2}sets af Buitding Plans (1}set of Energy Forms;F2-0-W Permlt far new cons#rttcfion, _ <br /> Minimum ten(10)working days after submittal ate. Required ansite,Const�uction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities 8�1 dumpster;Site Wotk Pe it for subdivisionsAarge projects <br /> COMMERCIAi. Attach{3}complete sets af Building Pians ptus �ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal ake. Required ansite,Canstruction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dUmpster.Site Work Per it for atl new pro�ects.Atl commerciaE requirements must meet compiiance <br /> StGN PERMIT Attach{2)sets of Engineered Plans. <br /> "`"PROPERTY SURVEY required for all NEW onstruction. <br /> Diiections: <br /> Fill out application completely. <br /> Owner&Contraator sign back of appiication,notarized <br /> If over�2500,a Notice af Commencement is required. ( C upgrades ovar 57500) <br /> "" Agent(for the contractor)or Power of Aktomey(for the owner) ould be someone with notarized letter from owner authorizing same <br /> f3VER THE CQUN7ER PERMtTTiN� (Front of Applica#ion O ly) <br /> Reroofs if shi�gles Sewers Service Upgrades AIC ences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs R <br />