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<br />813-780-0020 <br /> <br /> <br />City of lephyrhills Permit Application <br />Building Department <br /> <br />Dale Received <br /> <br />Owner's Name <br /> <br />Ownel'sAddress 16g-85 \ L.,~ ~ <br /> <br /> <br />Fee Simple Titleholder ~e I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />I <br />I <br />I <br />1/7 I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Tllleholder Adctess I <br /> <br />1<5'8'd~ <br />I <br /> <br />WORK PROPOSED <br /> <br />NEWCONSTR <br />INSTALL <br />SFR <br /> <br />BLOCK <br /> <br />\L,~ at, LOT# <br />I PARCElID#U \ -alo.-B\ -CO/C-Qk2lY).ollCJ <br />(OBTAINED FROM PROPERTY TAX NOnCE) <br />B ADDtAL T 0 SIGN 0 MOVE 0 DEMOLISH <br />REPAIR <br />c==J COMM 0 OTHER <br />o FRAME 0 STEEL 0 OTHER [ <br /> <br />\~'D"-oJ. t/~~~ lLJCDd. ~\~('){,3 <br /> <br />SQ FOOTAGE I \ \n C\ I HEIGHT I '-I" <br /> <br />SUBDMSION <br /> <br />B <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTON 0 <br />DESCRIPTION OFWORK I \ ~ 1-- \-\, <br />BUILDING SIZE I \ a"'f-. \ ~ I <br />o BUILDING 1$ \ \~tQD ,00 <br />o ELECTRICAL 1$ <br />o PLUMBING 1$ <br />o MECHANICAL 1$ <br />o GAS 0 <br />FINISHED FLOOR REVATIONS I <br /> <br />Address <br /> <br /> <br /> <br />VALUATION OF TOTAl CONSlRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WRE.C <br /> <br />-- <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />Address <br /> <br />t\~~~ ~ <br />license # Ieee. \ ~ g L4-S- <br />~ <br /> <br />~ <br /> <br />FEE CURRENr <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />-+ <br /> <br /> License # <br />~ FEE CURRENr ~ <br /> License # <br />~ FEE CURRENr ~ <br /> License # <br />~ FEE CURREM" ~ <br /> License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address l <br /> <br /> <br />~I~~~TURE I <br /> <br /> <br />Address I <br /> <br />-t <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />RESIDENTIAL <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms <br />Minimum ten (10) worling days after submittal date. Required onsite, Construction Plans, S.n~ary Facilities & 1 dumpster <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) worl<ing days after submittal date. Required onsite, Construction Plans, S"n~ary Facilities & 1 dumpster <br />All commercial requrements must meet oompliance. <br />Attam (2) sets of Engineered Plans. <br />'-PROPERTY SURVEY requred for all NEW construction. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500. a Nolice Ii Commencement is required. (AlC upgrades Ofer $5000; <br /> <br />Agent (for ltle oontractor) or Power of Attorney (for the owner) woutJ be SOmeone wlh notarized letter from owner authorizing same <br /> <br />OVER TIiE COUNTER PERMITllNG (Fronl of Application Ono/) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />Drivewa}'S <br /> <br />Fences (PlotlSurveylFootage) <br />