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813-780-0020 City of ephyrhills Permit Application Fax-e��z�, / <br /> ,. -- '"" ,` Building Department ����� /� �� �� <br /> �. <br /> L� J���d� <br /> Date Received Phon ContactforPertnitting � � �� �— <br /> Owners Name Y' � �liC� Owner Phone Number <br /> Ownels Address l✓Q � ✓�Q�� /� �� Owner Phone Number <br /> Fee Simple TiUeholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> , ' � <br /> JOB ADDRESS cJ� 9� � I� LOT# <br /> �I JJ �2 dn <br /> SUBDIVISION PARCELID# � �oc 'D�BO�T/����—dOo7d �jQ/ OT d/'�L. <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT 0 SIGN Q 0 DEMOLISH I <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER i <br /> TYPE OF CONSTRUC770N Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK ����/T /�� SC/ ���SS�� <br /> BUILDING SIZE SQ FOOTA E� HEIGHT � <br /> �BUILDING $ ALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ MP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ���� �f L <br /> �L.J <br />' �MECHANICAL $ ��t ALUATION OF MECHANICAL INSTALLATION � <br /> /L�5✓pP <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COM PANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL (� COMPANY /r �/ <br /> SIGNATURE REGISTERED Y/ N FEE CURRE Y N <br /> Address �/� �! �� License# ���v��� ( <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1'1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building lans;(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,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster,Site Wo Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plan plus a Life Safely Page;(1)set of Energy Forms.R-O-W Pertnit for new construdion. <br /> Minimum ten(10)working days after sub ittal date. Required onsite,Construction Pians,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Wo Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. • <br /> ""PROPER7Y SURVEY required for ail EW construction. <br /> Directions: <br /> Fill out application completely <br /> Owner 8 Conlractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is require . (A/C upgrades over$7500) <br /> " Agent(for the conlractor)or Power of Attorney(for the o ner)would be someone wilh notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITfING (Front of Applica ion Only) <br /> Reroofs if shingles Sewers Service Upgrades A/ Fences(PIoUSurvey/Footage) <br /> • Driveways-Nol over Counter if on public roadways..nee s ROW <br />