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813 -780 -0020 City of Lephyrhills Permit Application i a1:3- isU -UO21 <br /> Building Department /(Cf.( <br /> Date Received Phone Contact for Permittin, - <br /> Owner's Name p ; : NI // I pwner Phone Number <br /> up1 Sk; <br /> Owner's Address 4 // 3 // 7 . Owner Phone Number I <br /> Fee Simple Titleholder Name . ( P d j g(; j C 6,( 2- Owner Phone Number <br /> Fee Simple Titleholder Address (fie / J a ,jj j 6 V/ e14 i <br /> JOB ADDRESS LOT # <br /> SUBDIVISION , PARCEL ID# // - 0� ( - 0O / 0 - lJ Oa 0 - U O / 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � 1 NEW CONSTR n ADD /ALT I 1 SIGN n n DEMOLISH <br /> � INSTALL I I REPAIR <br /> PROPOSED USE I SFR I COMM I I OTHER I <br /> TYPE OF CONSTRUCTION I BLOCK ri FRAME _ STEEL n I I <br /> DESCRIPTION OF WORK I R,..._ r 0 (n ' Cf /A I <br /> ' //f/ c _ /r(/ /e /- -.- j(/ ? <br /> BUILDING SIZ 16 t SQ FOOTAGE gZ 1 HEIGHT I / <br /> []BUILDING $ ja 0 , o 0 VALUATION OF TOTAL CONSTRUCTION <br /> []ELECTRICAL $ AMP SERVICE n PROGRESS ENERGY I W.R.E.C. <br /> 1 1PLUMBING $ <br /> 1 (MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> I GAS I] ROOFING n SPECIALTY I 1 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA []YES NO <br /> BUILDER / / COMPANY °I ' ' o t eo e <br /> SIGNATURE G-.jK —c_ REGISTERED rpm . 1 FEE CURREN rej El <br /> Address 1 �� S L A // M 5 z ,-/If' 1 License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I <br /> Address I I License # I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURREN I Y/ N <br /> Address ( <br /> 1 License # I I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I <br /> Address i <br /> 1 License # 1 <br /> OTHER COMPANY 1 <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREN I Y/ N I <br /> Address 1 License # I I <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set 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 Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set 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 Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> * ** *PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill 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 the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />