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i <br /> e�aasaoozo City of phyrhills Permit Application F�-siaaeaooz� <br /> � r' Building Department <br /> Date Received � 2� ' phone o�tact for Permitting V�� ��" �� <br /> ...�_.�..�...r...�_�_T_�_ E_ti_..1_�"'1 <br /> Owner's Name Q � L<� Owner Phone Number f.J 1-W V��v l� <br /> Owner's Address (�\Tf7�V��p.��� �� .7 � 1 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple TitleholderAddress ' <br /> JOB ADDRESS `„3 LOT# � <br /> SUBDIVISION E Y PARCEL ID# �S�ZS'2'��� "���O <br /> (OBTAINED FROM PROPERTV TAX NOTICE) <br /> WORKPROPOSED B NEWOONSfR� ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � COMM 0 OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE I)1 �"�/ SQ FOOTAG '�vR/ HEIGHT ��R� <br /> �BUILDING $ V LUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ A P SERVICE 0 PROGRESS ENERGY 0 W.R.E.C. <br /> OPLUMBING $ <br /> �MECHANICAL $ �� V LUATION OF MECHANICAL INSTALLATION /���� t �t��,� <br /> T� v , � <br /> �GAS 0 ROOFING Q SPECIALTY 0 OTHER� � ��i„(� <br /> �e <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA YES NO <br /> BUILDER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE � REGISTE Y/ N FEE CURRE� Y/N <br /> C �� <br /> Address I License# <br /> MECHANICAL COMPANY � �V A��,L�VC�, <br /> SIGNATURE REGISTERED N FEE CURRE� Y/N <br /> Address {.� �. License# CW r�v <br /> 32-12� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IllfilllllltPlll { 11 ( llltf / llll { t1111E110111 [ 1 / IIi, 1 / { � tl { i1 / 1llti ! / i <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building P ans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after subm ttal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed, <br /> Sanitary Facilities�1 dumpster;Site Wo Permit for subdivisions/large projecls <br /> COMMERCIAL Attach(3)complete sets of Building Plans lus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days after subm ttal date. Required onsite,Construc6on Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster Site Wo Permit for all new projects.All commerciai requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "'•PROPERTY SURVEY required for ail EW construction. <br /> Directions: <br /> Fill out application completely <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 contractor)or Power of Attomey(Torthe o ner)would be someone with notarized letter from owner authorizing same <br />