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813 -780 -0020 City of Lephyrhills Permit Application tax- tsl;i- /tSU -UUL1 <br /> Building Department f ! (� 3 <br /> � <br /> Date Received V + 1 <br /> Phone Contact for Permittln, <br /> Owner's Name r e /, � e Owner Phone Number ,f S • "'a" at 4 <br /> Owner's Address S� Owner Phone Number <br /> Fee Simple Titleholder Name . Owner Phone Number <br /> Fee Simple Titleholder Address <br /> s 87 '� <br /> JOB ADDRESS a'? ZS -/ _.7'4 l s-r"- <br /> 1� 11 � _t,. LOT# /67 <br /> SUBDIVISION s/f /r11�11d d !a p7� ** 2 , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR R ADD /ALT I I SIGN I I DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE I SFR I COMM I I OTHER I $ t k_ 8,., _ <br /> TYPE OF CONSTRUCTION n BLOCK ri FRAME I I STEEL n I I <br /> DESCRIPTION OF WORK I cc - r & !C 8 x 7 c -,c tt <br /> BUILDING SIZE ( 7 Xk' SQ FOOTAGE I 975 HEIGHT 7 <br /> []BUILDING $ d=y <br /> VALUATION OF TOTAL CONSTRUCTION <br /> []ELECTRICAL $ AMP SERVICE I PROGRESS ENERGY n W.R.E.C. <br /> [] PLUMBING $ <br /> []MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> []GAS I ROOFING El SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA []YES NO <br /> ■, q t <br /> BUILDER `---" COMPANY ( / 'l'! '`-- <br /> SIGNATURE �„_ REGISTERED I Y/ N FEE CURREN I Y/ N <br /> Address License # I I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREts I Y / N I <br /> Address ( I License # I I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y / N I FEE CURREP I Y/ N I <br /> Address I License # I I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREt I Y/ N I <br /> Address 1 <br /> 1 License # I <br /> OTHER COMPANY <br /> I <br /> SIGNATURE <br /> REGISTERED I Y/ N I FEE CURREN I Y/ N I <br /> Address I License # 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 Attomey (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 />