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813-780-0020 City of ephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> • "'i Z � <br /> � �� � <br /> Date Recelved Phon ContactforPermitting `Z'� � � � <br /> Owner's Name C(A (?\ �, � Owner Phone Number � J � 7 DoZ'(��Ja <br /> Owner's Address �'1��, Owner Phone Number ��O�U� d"� � . 5 <br /> Fee Slmple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address I <br /> JOBADORESS �`J LOT# � <br /> sue�ivisioN D t� C:`S CEL ID# {5= L�- l- U1�io �,c,ei-- v� o <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR� ADDIALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK �Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK C G�� �'T6h \P S\S <br /> BUILDING SIZE SQ FOOTA E� HEIGHT � <br /> �BUILDING $ LUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ M��`�.� MPSERVICE Q PROGRESSENERGY Q W.R.E.C. ' <br /> ., <br /> QPLUMBING $ <br /> I `�MECHANICAL $ ALUATION OF MECHANICAL INSTALLATION • <br /> ������ <br /> QGAS Q ROOFING Q SPECIALTY � OTHER � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER COMPANY <br />� SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IELECTRICIAN � /!/ COMPANY �.��I�S 1 1 �Q.�'��(�Q2, GIEL.O�IC+�—�L. <br /> SIGNATURE / REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ��00� N2 � t7C� ('T1��. U!Y< L 5�(0�0� License# C � .� <br />' PLUMBER CqMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N� <br /> Address Lfcense# <br /> MECH CAL �COMPANY �is. /y)��(.,P317�/�alJf nC <br /> SIGNA URE REGISTERED Y/ N FEE CURREA Y/ _ <br /> Address �"�� 3��Ave �/� �L 3�(O�Jp� License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> 111111111111111111111111111 IIIIIIIIIIIIIIIIIIIIIIIIIIIIItlllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building lans;(1)set of Energy Forms;R-O-W Permit for new constructfon, <br /> Minimum ten(10)working days after sub ittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Wo Pertnit for subdivisions/large projecls <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Lifa Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after sub ittal d81e. Requlred onsite,Conslruction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster Site Wor Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> ""PROPERTY SURVEY required for all EW construction. <br /> Directions: <br /> FIII oul application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> Ii over$2500,a Notice of Commencement Is requlre . (A/C upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attorney(for the o ner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIT77NG (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 />