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� <br /> a��-7eo-aozo City of ephyrhills Permit Application Fax-813-780-0021 <br /> . - � Building Departrnent <br /> DateReceived — ��� $1� ��. Lf <br /> Phon CantadforPertnitting - <br />� �T��I-f TI"7�"t-T ' ' T�7T Q. 2 Q.Q� 2 <br /> Owners Name G 3��n.�-s b �'�' Qwner Phone Numher (�1 J �D D �cJ�U� <br /> Owners Address �� /L GJ- ' Owner Phone Numher <br /> Fee Slmple Titleholder Name n-v(�v i�cs� �� ' Owner Phone Number <br /> Fee Simple Trtleholder Address � L.J��' � � u ' <br /> JOB ADDRESS U� y � { C � � LOT# U�� <br /> SUBDIVISION �/�� h��l�sui pARCELID# D�+a`C..y+��'�D�l%"d����-�v05v <br /> (OBTAINm FRON PROPERTY TAI(NOTICE� <br /> WORK PROPOSED e NEW CANSTR� ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK L.Y�L. �S <br /> BUILDING SIZE � �' �"-"'"f" SQ FOOTA E �wo HEIGHT � <br /> QBUILDING $I�n i _1 /'l�2 LUATION OF TOTAL CONSTRUCTION <br /> L�tO `'1.J <br /> IQELECTRICAL $ �i� P SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> � "�.p� <br /> QPLUMBING $ d��� �,]��U [ � <br /> 1 1 � �� 1 <br /> QMECHANICAL $ LV ALUATION OF MECHANICAL INSTALLATION ����� � <br /> V C / <br /> OGAS Q ROOFING Q SPECIALTY � OTHER // �U ✓/,(!1]j! <br /> FINISHED ROOR ELEVATIONS FLOOD ZONE AREA OYES NO V - �Q�`C�� <br /> ► !n ,/��� U � <br /> � ,.� �-P <br /> BUILDER MPANY (.�t- G(�-�"-'� <br /> SIGNATURE REGISTEf2ED Y/N �cuwtEn Y!N <br /> Address � �(. F��u rJ" �(�+�m� �W'� License# � O � <br /> ELECTRICIAN COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y I N �cuwt�n Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N �e cuttf�n Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/N �cur�nn Y/N <br /> Address License# <br /> 1 1 1 t 1 1 1 1 t 1 t 1 1 1 ! 1 1 1 � 1 1 1 1 1 1 1 1 1 1 1 1 1 ! 1 � I I 1 � ! I f 1 1 1 1 1 l 1 1 1 ! 1 1 1 1 1 1 1 1 1 1 1 � 1 I <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building lans;('I)set of Energy Forms;R-O-W Permit for new construcSon, <br /> Minimum ten(10)working days after sub al date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster,Site Wo Pertnil for subdivisionsllarge projecls <br /> COMMERCIAL Attach(3)complete sets of Building Plans lus a Life Safety Page;(1)set of Energy Forms.R-O-W Permi[for new construction. <br /> Minimum ten(10)waridng days after sub ittal date. Required onsite,ConsWCtion Plans,S[ormwater Pians w/Silt Fence installed, <br /> Sanitary Fadlilies 81 dumpster.Site Wo Permit for all new projects.All commercial requiremenLs mus[meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all EW construclion. <br /> Directions: <br /> Fill out application comple[ely. <br /> Ownar&Contractor sign back of applicaGon,notarized <br /> If over 52500,a NoUce of Commencement Is requir . (AIC upgrades aver 57500) <br /> •' Agent(for the contractor)or Power of Attomey(for the o er)would he someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERINITTING (Front of Applica on Only) <br /> Reroofs if shingles Sewers Service Upgrades A! Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..nee s ROW <br /> � <br />