Laserfiche WebLink
� , • e��-�so-oozo City of ephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> Date Received Phon ContactforPermittin <br /> �rrr <br /> Owner's Name � �IJ Owner Phone Number g, � � � <br /> Owner's Address Qx � Owner Phone Alumber � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple TiUeholder Address <br /> , ' �JOB ADDRESS � ��I Q� ��(C� 9 1 LOT# <br /> SUBDIVISION PARCEL ID# O ° �` _ <br /> (OBTAINED FROM PROPERTY TAX NOTICE� <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEI Q <br /> DESCRIPTION OF WORK '�C! � (' (� C� <br /> BUILDING SIZE �-� SQ FOOTAG ,. HEIGHT � <br /> �BUILDING $ � V LUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ A P SERViCE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �n�� <br /> ��� I <br /> QMECHANICAL $ V UATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEV IONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY � � � [�) �!C � <br /> SICaNATURE REGISTERED Y/ N FE CURREI. Y(N <br /> Address � , � License# ���� � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y f N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERE� Y! N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE � ��is7Eaeo Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> I I 1 f 1 1 1 1 1 1 i i I 1 1 1 1 1 1 1 1 1 A 1 I Q 1 1 1 1 1 1 1 1 1 1 1 1 1 Y 1 1 1 1 1 i 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 A 1 1 1 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Pla s;(1)set of Energy Fortns;R-O-W Pertnit for new construction, <br /> Minimum ten(10)woricing days after submitt I date. Required onsite,Construction Pians,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work ertnit for su6divisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans pl s a L'rfe Safety Page;(1)set of Energy Forms.R-O-W Permi[for new wnsVuction. <br /> Minimum ten{10)woricing days after submitt I date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, i <br /> Sanitary Facilities&1 dumpster.Site Work ermit for all new projects.All commercial requirements must meet compliance � <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "•*PROPERTY SURVEY required for all NE construction. <br /> Directions: <br /> Fill out application completely. �z _�. `'- - <br /> Owner&Contractor sign back of application,notarized ..,. <br /> If over$2500,a Notice of Commencement is required. A/C upgrades over$7500) � <br /> " Agent(for the contrector)o�Power of Attomey(for(he,own r)would be someone with notarized letter from ovmer authorizing same <br /> OVER THE COUNTER PERMITI'ING (Front of Applicatio Only) I <br /> Reroofs if shingles Sewers ,Service Upgrades%VC Fences(PIoVSurvey/Footage) f� <br /> . � <br /> Driveways-Not over Counter if on pu6lic roadways..needg OW <br />