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:- 3' <br /> r <br /> � � 81&780-0020 City of ephyrhills Permit Application Fax-613-780-0021 <br /> � Building Department <br /> Date Reeeived � Z��� phon Contact for PermitGn <br /> Owner's Name ��'1( \ L 1 Owner Phone Number � " - y <br /> Owner's Address � L,.C� r t„�J Owner Phone Number <br /> Fee Slmple Titleholder Nama Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �-1"� G�� `e 1 ,Q ��. V(�I� LOT# � <br /> SUBDMSION PARCEL IQ# - / <br /> (OBTAINED FROM PROPERTY TAX NOTCE) <br /> WORK PROPOSED e NEW CONSiR B 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 /> DESCRIPTION OF WORK � \ � t C C�.��� � � C�S <br /> BUILOING SIZE SQ FOOTAG � HEIGHT <br /> QBUILDING $ /� d V UATION OF TOTAL CONSTRUCTION <br /> �.1 <br /> Q ELECTRICAL $ P SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHANICAL $ V UATION OF MECHANICAL INSTALLATION � ���� <br /> '�1 <br /> OGAS Q ROOFING Q SPECIAL'fY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> f� � � r. <br /> BUILDER OMPANY .-y� <br /> SIGNATURE r��is�r�o Y/ N F� w�n /N /.��I� <br /> Q ��/ <br /> Address �� License# Q 5�U � ���j <br /> ELECTWCIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N �Cuw2F1. Y/N <br /> Address License it <br /> PLUMBER COMPANY <br /> SIGNATURE r�ciST�o Y/ N r�Wriaen Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGI5TERED Y! N �cuttrt�n Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE r�oisrEaED Y/ N �cur�n Y/N <br /> Address License# <br /> 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 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 A 1 1 1 1 1 1 1 I 1 1 1 1 1 I 1 1 1 1 1 I <br /> RESIDENTIAL Attach(2)Plot Plans;(2)seTs of Building Plan ;(1)set of Energy Fortns;R-O-W Pertnit for new construction, <br /> Mfnimum ten(10)working days efter suhmiria date. Required ansite,ConsWctlan Pla�u,Stormwater Plans w/Sllt Fence installed, <br /> San'dary FaciliUes&1 dumpster,Site Work P rtnit far subdivisions/large proJects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plu a LHe Safety Page;(1)set of Energy Fortns.R-o-W Permit for new construction. <br /> Minimum ten(10)working days after submitta date. Required onsite,Construction Pfans,Stormwater Plans w/Silt Fence fnsfalled, <br /> Sanitary FaciliUes S 1 dumpster.SNe Work P rtnit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plens. <br /> ""PROPERTY SURVEY required for alI NE consVuction. <br /> Diractlons: <br /> F11 out appliption completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a NoBce of Commencement is required. ( C upgrades over ST500) <br /> " Agent(for the contractor)or Power of Attomey(for the owne would be someone with notarized letter from ownar authorizing sama <br /> OVER THE COUNTER PERMI7TING (F�nt of Application nly) <br /> Reroofs ff shfngles Sewers Service Upgrades AIC Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs R W <br />