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813-780-0020 City of ephyrhills Permit Application Fax-81 ao-oo2� <br /> _ 'J <br /> � Building Department <br /> Date Received r Q 'f 7 �j�% � �j�,1 <br /> � U I`"� Phon Contact for Per`m '�� G —�(�( V <br /> 1 1 1 1 1 1 1 1 /1 1 1 i 1 � r <br /> Owner's Name ��� l� Owner Phone Number <br /> % <br /> Owner's Address �� P s Owner Phone Number <br /> Fee 5lmple Titleholder Name ner Phone Numb <br /> Fee Simple Tltleholder Address <br /> JOB ADDRESS J�1 C���1 LOT# � I <br /> SUBDIVISION PARCEL ID# J�"25�2�`Q�Q�°���J�l.e°�/G� <br /> (OBT/UNED FROM PROPERTYTA%NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADDlALT � SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q � <br /> DESCRIPTIONOFWORK ��IOCGc�, �x15 I� "'�-�11'k 5' VI1'1k,(,QY �.1�Q�S ��1 / <br /> BUILDING SIZE SQ FOOTA E 11�`i ��/w�/ <br /> 4� HEIGHT �, <br /> OBUILDING $ �' �(r � <br /> ALUATION OF TOTAL CONS RUCTION �i q,J ,� , r <br /> QELECTRICAL $ MP SERVICE PROGRESS ENERGY W.R.E.C. <br /> OPLUMBING $ � <br /> QMECHANICAL $ ALUATION OF MECHANICAL INSTALLATION U 3 v <br /> QGAS � Q ROOFING Q SPECIALTY 0 OTHER � �Lv( \ �/P���j' <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO �� � � <br /> BUILDER COMPANY P�ea�l� ��c� � r�r��,Y Ca � U <br /> SIGNATURE REGISTERED Y( N FEE C RE� Y/N <br /> Address f��]�jf�' ���I�T1� �E�1 (,-f��1P �i.(.�O��li��'f. '',' License# ��{�.'�,I,�`,l� ��lL��a - <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> 111111111111111111111111111 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItIII <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building lans;(1)set of Energy Forms;R-O-W Permit for new construcUon, <br /> Minimum ten(10)working days afler sub ittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Wor Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <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 Wor Pertnit for all new projects.All commercial requirements must meet wmpliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all 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 require . (A/C upgredes over$7500) <br /> " Agent(for the contractor)or Power of Attomey(for the o er)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Appiica on Only) <br /> Reroofs if shfngles Sewers Service Upgrades A/ Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..nee s ROW <br />