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513-78o-0020 City of Lephyrhills Permit Application rax-ts,s-f0u-w4' <br /> Building Department <br /> Date Received =_-Phbn9-Cbhtabt-fbr Permitting` O(J /! — S3 <br /> q 3� <br /> Owner's Name � (/�� 1 0 � Owner Phone Number —T_7 <br /> Owner's Address .�/ f( 'S� Owner Phone Number <br /> Fee SimplelTitleholder Name OwnerPhone Number, ' <br /> Fee SimplelTitleholder Address <br /> I q I <br /> JOB ADDRESS / I ' I S LOT# <br /> SUBDIVISION' PARCEL ID# <br /> (OBTAINED FROM PROPERTY.TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR' ADDIALT 0 SIGN = = DEMOLISH <br /> = INSTALL. e REPAIR <br /> PROPOSED;USE = SFR = 'COMM Q OTHER <br /> TYPE`OF CONSTRUCTION 0: BLOCK = 'FRAME Q STEEL Q. <br /> DESCRIPTION OF WORK <br /> BUILDING°SIZE SQ FOOTAGE $ S HEIGHT <br /> =BUILDING. VALUATION'OF TOTAL CONSTRUCT.10 <br /> =ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> i <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ` <br /> =GAS ROOFING. Q. SPECIALTY. _ -OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> :BUILDER COMPANY " <br /> SIGNATURE REGISTERED Y/ N' . FEE CURREh <br /> Address L-icense.# ; <br /> i <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N .FEE CURREN Y/N. <br /> Address License# =� <br /> PLUMBER. 'COMPANY <br /> SIGNATURE ' REGISTERED Y,•/ N; ,. : .FEECURREfi,_ Y/N. . <br /> w" <br /> Address .Licerise#;-'- <br /> MECHANICAL. . COMPANY, <br /> SIGNATURE" REGISTERED Y I N FEE:CURREn Y/N . <br /> Addedssw: License.#.1 <br /> OTHER`'_p• ... COMPANY <br /> :'SIGNA REGISTERED Y/.N FEE:CURREN Y/ j <br /> rr ! <br /> �aa�es •C.CC- o <br /> :RESIDENTIAL2;,•> Attach::2 Plot;Plans; 2 sets:of;Buildiri Plans^`1R-,set-of'Ener• `Forms R Q-IN ermit:for.new,coristiuction <br /> ^� 2,.� ,...�,)},.,�,. 5 .... <br /> xd5,-.,r:,-< Minimum`tear,l0 workin'"da' 'afte':s"utirriittal.date.:xRe uire'd onsite'Constructi='Plans Storm,Wer Pl-I sew Silt Fence installed,' <br /> :;: .::.•3; r... ...:_. ,r. , (,... n / <br /> Sanita: FacilitiesL8�0T;dum ste Sife?W6rk:Rent <br /> rY.�, p,.,�r., ,:, it:for subdivlsionsllargeprojects <br /> ;''•;:COMMERCIAL Attach'(2)complete'sets of`Building Plans plus a Life Safety'Page;(1)set of Energy Forms.R-0-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Slit Fence installed, <br /> Sanitary Facilities&:1 dumpster.Site Work,Permit fo04ll-ne*0rojects.All commercial requirements must meet compliance <br /> SIGWIRtRMIT "Attach'(2)sets;of Engineered;Flans:i.., •...: .. <br /> ""PROPERTY SURVEY, <br /> _required.,for.all.NEW consUuction.-., <br /> _. <br /> -------------- <br /> Fllifout:application completely. <br /> O-•wrier`&Contractor sign.back of application,notarized <br /> If over''$2500i.a Notice:of:Commsncement Is required. (AIC upgrades over$7500) <br /> Agent`(forr"t ieicorittaOor)or°Power of-Attomey(for'the owner)would fie someone with notarized letter from owner authorizing same <br /> "`,OVER':THE COUNERµPERMITTING._.._,. .,(copyofcontract;required) ' <br /> s'.broofS_if.'shIn§Ies SdWers_ Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public'roadwaysneeiis'R01N <br />