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a��-�so-oozo City of ephyrhills PeRnitApplication Fax�1&780-0021 <br /> Buiiding Department <br /> , Date Received � phone ntact for Pertnitting �� U � <br /> Owners Name IV 1..,� 1 � l� Owner Phone Number 1 <br /> OwnersAddress q�a_ AZ. OwnerPhoneNumber <br /> Fee Simple Titleholder Name �F'� Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �t lX1• LOT# � <br /> SUBDMSION 'L PARCELIQq � '� 'd'�" �.(J' , <br /> (OBTAINm FROM PROPERfYTAX NOTIC� <br /> WORK PROPOSED NEW CoNSrtt ADD/ALT Q SIGN Q Q DEMOLISH <br /> � INSTALL e REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> TYPE OFCONSTRUCTION Q BLOCK Q FRAME Q STEEL � <br /> DESCRIP'iION OF WORK <br /> BUILDING StZE 1 X � I SQ FOOTAG 51 HEIGHT � <br /> �BUILDING S Qp V UATION OF TOTAL CONSTRUCTION ��LI�� <br /> -1 <br /> �LECTRICAL $ P SERVICE Q PROGRESS ENERGY Q W.RE.C. <br /> �LUMBING $ ^ �� <br /> 0/% <br /> �1ECHANICAL $ V UATION OF MECHANICAL INSTALLATION ' � � �r <br /> I ' 1 <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER 2'��� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ����'� <br /> )✓ <br /> �_�+� <br /> BUILDER � COMPANY , VG „J/ , <br /> SIGNA7URE ' RE�is7EaEO Y N FEECURREA N ` ,n,���,�" <br /> Vl �7 �` 1 <br /> Address 1 l� � � Licerue# � �Z�L�� ���� <br /> ELEC7RICIAN COMPANY u� C. <br /> SIGNATURE REGISTEF2E� N �cuw�En !N�' <br /> Address � p ', licetue# �Z <br /> PLUMBER COMPANY f`�lC""1 � <br /> SIGNATURE REGISTERFD Y N FEECURREt� N <br /> Address � License# <br /> MECHANICAL COMPANY ,S �l� <br /> SIGNA7URE REGISTEF2ED N FEECURREA N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNA7URE REGISTEFtm Y/N FEECURREt� Y/N <br /> Address License# <br /> 11111'11111111111111111111111111111111111111111111111111111111111111 <br />, RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PI ns;(1)set of Energy Fortns;R-0-W Pertnft for new consVuction, <br /> Minimum ten(10)working days after subm' al date. Required onsite,ConsVudion Plans,Stortnwater Plans w/Sitt Fence instailed, <br /> SanRary Facilities 81 dumpster,Site Work Pertnit for subdivisions/large projects <br />' COMMERCIAL Attach(3)comptete sets of Building Plans lus a LiFe Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new consWdion. <br /> Minimum ten(10)working days after subm' al date. Required onsi[e,ConsWc[ion Plans,Stormwater Plans w/Silt FerKe installed, <br />' Sankary Faalilies&1 dumpster.Site Work Permit for all new projeds.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engirreered Plans. , <br /> ""PROPERTY SURVEY required far all W consWction. <br /> Directlons: <br /> Fill out application completety. <br /> Owner 8 Contractor sign badc of application,rrotarized <br /> If over E25�0,a Notice of CommencemeM is required (A/C upgrades over s'7500) <br /> "' AgeM(for the contractor)or Power of Attomey(for the er)would be someone with rrotarized letter from owner author�ng same <br /> OVER iHE COUNTER PERMITTING (Front of Applicati n Onty) <br /> Reroofs'rf shingles Sewers Service Upgrades A/C Fences(Plot/SurveylFootage) <br /> Driveways-Not wer CouMer if on public road�rays.. ROW <br />