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� 813-780-0020 City of ephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � <br /> Phon Contact for Permitting -- <br /> __ � <br /> Owner's Name ��'r! S m�s Owner Phone Mumber g�3 J ��g� �G S� <br /> Oumer's Address ��d 3O ��ue- �� �� e- Owner Phone Number <br />� Fee Simple Titleholder Name Owner Phone Number <br /> I Fee Simple Titleholder Address <br /> JOBADDRESS 3�b3u ��� �a '� ^ LOT# 32 <br /> I <br /> SUBDI!lISION �5 ��e� PARCEL ID# �3�Z�" L l— O i d0^ CSCaOt�0 — 0 32p I <br /> i __ -�._-_ - _ ._�__ ,- - _ - - -�-- _�--- --_ - -- -----,-�OBTAINED°FROM PROPERTY-TAX NOTICE)----__�_-��_ - - <br /> WORK PROPOSED � NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL B REPAIR u�R{_ r�,F' <br /> PROPOSED USE [� SFR Q COMM Q OTHER <br /> 7YPE OF CONSTRUCTIOM [� BLOCK Q � FRAME Q STEEL Q - <br /> DESCRIPTION OF WORK `�� d�"� �1� rG J ��� �� ' ����" 5 u'P��'L �� <br /> BUILDING SIZE SQ FOOTA E� HEIGHT I <br /> QBUILDING $ -- � V LUATION OF TOTAL CONSTRUCTION II <br /> �22.�'t . �(o <br /> QELECTRICAL $ A P SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ��� <br /> s <br /> QMECHANICAL $ V LUATION OF MECHANICAL INSTALLATION ��� <br /> QGAS �] ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER -- -- — — --COMPA7VY�--- —-----—=— ------ -— -- -- - - -- <br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y/N <br /> Address License# <br /> PLUAABER COMPANY <br /> SIGfdATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IVIECHANICAL COMPANY <br /> SIGIdATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY '�y rn�'+"' �1 i �c . <br /> SIGRIATUitE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 3b413 S25�f, �cph �h�1ls� 335�1 _ �icense# CCG 132S5d5 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building PI s;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submit I date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work ermit for subdivisionsAarge projects � <br /> COMMERCU�L -Attach(3)complete sets of Building Plans pl s a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submit I date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.�Site Work ermit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •"""PROPERTY SURVEY required for all N W constructlon. - <br /> Directions: � � <br /> Fill out appiication completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 32500,a Notice of Commencement is required. (AIC upgrade's over 57500) ' <br /> " Agent(for the contractor)or Power of Attomey(forthe own r)would be someone with notarized letter from owner autliorizing same <br /> OVER THE COUNTER PERMITTIIVG (Front of Applicatio Only) • �� <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs OW ' <br />