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�,,,-,o�w��u t;ity ot Lephyrhills Permit Appiication Fax-813-7saoo2� <br /> Buildtng Department <br /> ,te Recelvad Phone Contact for Parmiitin �r� ��� - $�� <br /> F�rjl.�s j)�j.��' ��/ v+p�-TA- Owner Phone Number g�3 r �JJ' -' �22 <br /> rne�'s Name �� <br /> rner's Address p� �� +� ��✓f Ll"� Owner Phone Number <br /> e 5lmpie Titiehoidar Name � � Owner Phone Namber _,_, <br /> e Simple Tltleholder Address <br /> �B QDDRESS �c�a�� ,/� � JZ � 1L �� . 335 �- LOT# [� <br /> �BDIViS10N �- � P,aRCE��o# /1 �/ Db,l D .1'��lb�C3 L311�9� � <br /> (OBTAlNED FRONI PROPER'fY TAX NOTIGE� <br /> �RK PROPOSED e NEw CONSSR� ADQlALT [�,] SIGN C] Q DEMfJl.I5H <br /> iNSTALi. REPAiR <br /> :OPOSED USE Q 5FR Q COMM � OTHER <br /> PE OF CONSTRUCTION [� BLOCK � FRAME � STEEL Q <br /> :SCRIPTION OF WORK �f� G��.qsN �`bl� r � +C+ ��'-�� � °� ��� <br /> 11Lp1NG SIZE C � SQ FOt�TAGE Q�__� HEIGNT �__� 4 � <br /> QBUILOiNG �� VALUATION OF TOTAI CONSTRUCTION <br /> QELECTRICAL (;&r4-� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> L <br /> �P�uM�iN� ���J <br /> OMECHANlCAL $ �L�G��� �rj 'VALUATfON OF MECHANICAL fNSTALLATION <br /> QGAS [� ROpFING Q SPECfA�TY � OTHER <br /> IlSHED FLOOR ELEVATlQNS �� FLOOD ZGiNE AREA QYES NO <br /> fLDER COMPANY <br /> iNATURE REGtSfiERED Y/ N FEE CURREM1 Y 1 N <br /> Address Ltcense# ( �----� <br /> =_GTRICtAN COMPANY <br /> iNATURE REftSTERBD Y/ N FEE CURRE� Y/N <br /> Address License# ( � <br /> JMBER � COMPANY <br /> �NA7URE � REGIS7ERED Y/ N FEE CURRE� Y J N <br /> Address License# �� � <br /> ct+�w�c� , _ `` . coMpa�nr ,�1�i2S/"���PR-Ne Csr-3� �-- �/� ��,, <br /> NATURE �n��������' REGISTEREO Y/ N FEE GURREE Y/IV <br /> Address � License# �L/r�� ��`��5� <br /> iER � � Ct?MPANY <br /> NATURE REGiSTERED Y/ N �e cuRaen Y!N <br /> Address License# � ` i � <br /> clDENTIAL Rttach(2)Plot i�lans;(2}sefs of Building Plans;(1}set of Energy Fortns;R-O-W Permlt far new construcHon, <br /> Mlnimum ten(10j worlcing days aftersubmitta!date. Requlred onsfte,Constructfon Pians,Stottnwater Pians w!Sik Fence installed, <br /> Sanitary FaclllUes&1 dumpster;Sita Work Permit fot subdivislonsJlarge proJects <br /> AMERCiAI� Attacfi(3}campiete sets of Building Plans plus a Llfe Safety Page;(1)set of Energy Fom►s.R-t?-W Permit for new constn�cNon. <br /> Minimum ten{10)working days after submitta!date. Required onsite,Constroction Pians,Stormwater Ptans w/Silt Fence installed, <br /> Sanitaryr Faciiities&1 dumpster.Site Work Petmit for atl new proJects.All commercial requlfemenGs must meet complfance <br /> N PERMiT Attach(2j sets of Engineered Plans. , <br /> ""PROPERTY SURVEY requlrec!for aii NEW constructlon. <br /> ctions: <br /> Ftll out application c�mpletely. <br /> Owner&Contractar slgn back of application,nota�tzed <br /> tf over�2500,a NotlCe of Commancem�nt Is requtred. (AfC upgrades ovar 57500j <br /> Agent(for the contractor)or Power af Attomey(for the owner)would be someona with notarized tetter from owner autho�iztng same <br /> ;R TNE COUN7ER PERMITTING (Front of Application On{y) _ : -, _ - '° �`;"' � _� , � <br /> �ofs if sh{ngles Sewers Service Upgrades A/C Fences(Ptot/Survey/Footage) � • '`"' • <br /> Driveways-Nat over Counter if on pub!(o roadways..needs ROW . , : , � .. , ' � '� �' <br /> Fr -.. ,.�.,-� . �.. ._r .. .r.-•:. ... ...,-._� ' <br />