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813-780-OU20 City of Lephyrhills Permit Application rax-rs�s-rrsu-uuci <br /> Building Department <br /> Date Received (�_ ) / _ <br /> PrrrTTrrrr hone Cbetact#or.Perinitting 3 CQ 1 �� <br /> Owner's Name r �V�fl �TI �►7 Owner Phone Number , <br /> Owner's Address. 9.50 A AVE M\S �� Owner'Phone Number <br /> Fee Simple:Titleholder Name'.. Owner'Phone Number, <br /> Fee Simple Titleholder Address JOB ADDRESS r 319 9115 0 6 LOT# <br /> SUBQII/ISION• PARCEL ID#. <br /> (OBTAINED'FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR`. - AD.DIALT SIGN' 0 �. DEMOLISH <br /> i El. .' INSTALL. B 'REPAIR 7� <br /> PROPOSED;USE. 0 SFR 0 :-COMM Q' OTHER <br /> TYPV0FCONSTR6CTI0N' 0'" BLOCK 0 FRAME Q. STEEL ._. <br /> DESCRIPTION bF wORK " A&Cd $Vvb & n•eid i-e�. Co <br /> BUILDINGSIZE . ' - S4_FOOTAGE :.HEIGHT <br /> =BUILDING $ VALUAT,ION'OF TOTAL CONSTRUCTION <br /> • n, <br /> =EL•ECTRICAL $nOOD� oo . AMP SERVICE �. PROGRESS ENERGY 0 -KkE.C. <br /> PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL.INSTALLATION <br /> =]GAS 0 ROOFING- Q_ SPECIALTY. = OTHER.- <br /> FINISHEDFLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> :BUILDER; COMPANY <br /> SIGNATURE REGISTERED Y'/ N-:..'' FEE:CURREN YIN. <br /> Address // Uceense.# <br /> fLEC,TRICIAN: •, !COMPANY <br /> �1n G <br /> .''SIGNATURE � / REGISTERED Y/ N . •FEE%CURRER.• Y/N " <br /> O� Ss DS�G � OO d #Address I , <br /> PCUMQER;,,;;. COMPANY::: <br /> SIGNATURE" 'REGISTERED _ Y/-N::? .FEECURREk:; Y/•:N :- . , <br /> Address. License.# .< . <br /> `.fiAECHANICAL"_` COMPANY... <br /> REGISTER`'SIGNATURE"'°' ED Y/,N FEE;CURRED . ..Y:/.N <br /> Addresss4,.. License.# <br /> OTHER. <br /> _ ,...g: . 7. <br /> CORAPANY <br /> ';SIGNATURE,Y;ry:$: i REGISTERED Y/N �FEECURREK Y/N <br /> t:. <br /> '1:16er1Se'# <br /> ,ti o s R 0=V11Pe 1t F`rnew,constuction <br /> -RESIDENTIALz. sAttach'(2)PlotPlans :(2)5etsof9uiling plans;(1)-set nfEnergy F rm , rm fo <br /> ... ...:-.,� �. -•-•r•, _ ,z., _ _s':r.•i...,.F:;,. 4:,.,.rr <br /> �. ,. ir♦imu xteri 1.0. `orlon'dasaftet. ubirmittataate. Re riired onsite'Constructton Plans',Stomdwater'PIOns wl°S(IYFence'installed;' <br /> Sancta: =Facilities;&ildwm ste.•Si s..W.ork Permit forsubdi5 sloras(la. e'io `cts- <br /> ia3'ORAMERCIAL Attaolr(2)coinplete`s'ets'ofBuilding Plans plus a l ife`Safefy'Page;(1)sef of Energy Forms.R-O-W Permit for'new construction: <br /> Minimum ten(10).working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fenceinstalled,_ <br /> Sanity Facilities&:1 dum ster.,Site Wo, Perrnitfor�ll=new.: rb acts.All commercial requirements must meet compliance <br /> rY .P . .,..,l� P 1 q _ p <br /> '.�51.GN;pER�lli' Attach• �)sets;o•fnEngfneeiedQlans��.: .._ . :f--. , ... ".•: <br /> ""PROPERTY SURVEY repuired:fgr,,alIVEW,,constructiom—, <br /> -.Fill.out:application.completely. <br /> 0Wnev&Contradtor sign-back of-application,notarised <br /> -Ifover.$2500;.a Notice,—of.—Commencement—Is required. :(A/C upgrades over$7500) <br /> :agent'(fdr tfieMcontractgr):tor>PoWer ofAttomey(for'the owner)would"tie someone with notarized letter from owner authorizing same <br /> OVERTHE COUNTER PERAMITTING:.:: ;:.(copy,:of contract:required) <br /> s:Reroofs'-ifafiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> iDiveways-Not over Counter if'on public�oadways::needs ROW <br />