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sm3-Aso-oozo City of Lephyrhills Permit Application rax-ups-ruu-uuz i <br /> Building Department <br /> Date ReceivedPhone Conts ct-for•Permittin 3 v <br /> 9: <br /> Owner's Name e_ dr Jv�(� 1' Owner Phone Number <br /> Owner's Address iLFL A942 Owner Phone Number <br /> Fee SimpleiTitleholder Name Owner'Phone Number <br /> Fee SimpleiTitleholder Address <br /> JOB ADDRESS S G W � Wc LOT# 00 l7 <br /> SUBDIVISION PARCEL ID#., 02 2.1 0 02620 <br /> (OBTAINED FROM PROPERTY,TAX NOTICE) <br /> WORK PROPOSED NEW.CONSTR ADD/ALT Q SIGN Q Q' DEMOLISH <br /> INSTALL. LjREPAIR " <br /> PROPOSED.USE SFR 0 COMM. 0 OTHER <br /> TYPE`OF CONSTRUCTION BLOCK 0 ' FRAME 0. STEEL Q: <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE S4`FOOTAGE= HEIGHT <br /> BUILDING VALUATION'OF TOTAL CONSTRUCTION <br /> t ll• <br /> t <br /> =ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C. <br /> OPj'LUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION . <br /> . <br /> 0 ROOFING Q SPECIALTY. Q OTHER QGAS � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA AYES NO <br /> 97 <br /> .-BUILDER COMPANY l,c- IGv` <br /> SIGNATUR ""` REGISTERED Y' F CURRF Y'/N <br /> Address License <br /> ELECTRICIAN COMPANY <br /> "'SIGNATURE REGISTERED Y/ N fEEPGURREN. Y/N. <br /> Address' license#, <br /> PLUMBER' COMPANY <br /> SIGNATURE REGISTERED. Y/ N " FEE CURRE�, Y/N`.. <br /> Address License#` <br /> MECHANICAL r COMPANY, <br /> "'SIGNATURE'' REGISTERED Y F.N FEE CURREA. <br /> License.#: <br /> OTHER;`~-J.• 'COMPANYLt <br /> I0 ATUREy REGISTERED Y/.N FEE CURREK Y/N <br /> Address. License'#. <br /> .. .,, ,� _. ,.. .,_ .-_�. ._.:::. •, - -' :.,,.,:.,, , -:: .- .r <br /> Attache 2)`'Rlot;P.,lans;'(2)sets ofBuilding Fians�( j°Set of EnetgyForms RO=V11 Perlriif_fornew;constFuction,." <br /> Minimum;teni(10)working,day.'oftersubmittal:lisle::Requireftrisite'Construction Plan_s,'Stormwater Plans w/Silt Fence.installed, <br /> ...4 <br /> Sanitary;;Facilities,&11 dumpstey;,,Sife;Work:Permit:for:§ulid(visions/large;projects <br /> ;tt'.OIYIMERCIAL Attac�iplete sefs'ofBdilding'Plans"plus a Life Safety`Page;(1)set of EnergyFomis.R-0-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary.Facilities&1 dumpster.Site Work Permit f&'all=new projects.All commercial requirements must meet compliance' <br /> SIGN:PERMIT -mAtta6fi7(2)sets,.*,Erigineeced Flans. <br /> ""PROPERTY.SURVEY required:for.,all.NEW,`construction.:.. <br /> '111,out`application completely. <br /> Owner'.&Contractor sign:back of application,notarized <br /> "If over:$2500;.-a Notice.of:Commencement is required. (A/C upgrades over$7500) <br /> Agent(for tFie*contractor):^or Power bf-Attomey`(fdr'the owner)'wobid`6e someone with notarized letter from owner authorizing same <br /> COVER-.TAE COUNERPERAA(TTING, .-:. :.(copyof contract.required) <br /> a- <br /> Aervofs;if;shingles Sewers .Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on publidroadiKiays.ne"e'ds R01N <br />