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813- 780 -0020 City of Lephyrhills Permit Application tax tsls - /aU -0021 <br /> Building Department <br /> Date Received <br /> / P - ne Contact for Permittin ! - <br /> !� jr �� � r, <br /> Owner's Name "A Owner Phone Number <br /> Owner's Address S • 12- , `i <br /> ' <br /> Owner Phone Number <br /> W ��'JP <br /> Fee Simple Titleholder Name . .� / Owner Phone Number I <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT # <br /> SUBDIVISION , PARCEL ID# 1/ /- 00/ - T c) kD <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT ( 1 SIGN n n DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [ SFR n COMM 1 1 OTHER <br /> TYPE OF CONSTRUCTION n BLOCK . F E 1 1 STEEL n 1 <br /> DESCRIPTION OF WORK I yl=y"e__,_____ <br /> BUILDING SIZE I I SQ FOOTAGE HEIGHT I <br /> 'BUILDING ( • $ 0 2 ... '/ p <br /> �, `t ( ---- VALUATION OF TOTAL CONSTRUCTION <br /> [ELECTRIC L I$ AMP SERVICE [ PROGRESS ENERGY 1 ._ ,W.R.E.C. <br /> [PLUMBI G I$ I i-1 <br /> [MECH NICAL <br /> $ VALUATION OF MECHANICAL ( & I HANICAL INSTALLA� "ION i 6 <br /> [ GAS 1-1 ROOFING n SPECIALTY 1 1 OTHER \- <br /> FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA [YES NO <br /> BUILDER <br /> I <br /> I COMPANY I <br /> SIGNATURE REGISTERED Y / N FEE CURRE� <br /> I � � 1 Y/N <br /> Address 1 License # I I <br /> ELECTRICIAN I <br /> I COMPANY <br /> SIGNATURE REGISTERED Y / N FEE C <br /> 1 � j uRREn 1 Y/ N <br /> Address 1 License # I I <br /> PLUMBER <br /> I <br /> I COMPANY 1 I <br /> SIGNATURE REGISTERED Y / N FEE CURREt <br /> I 1 1 Y / N 1 <br /> Address 1 License # I I <br /> MECHANICAL I COMPANY <br /> SIGNATURE REGISTERED Y / N FEE CURREN Y / N <br /> Address <br /> OTHER <br /> SIGNA ;41.....st Wit .� m <br /> AV" COMPANY �_ <br /> REGISTERED , FEE CURREJ ®'P <br /> Address A NA �� <br /> `��A i r!! 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 NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />