Laserfiche WebLink
813 -780 -0020 City of Lephyrhills Permit Application r ts,zi- f tw -uuz <br /> Building Department /'Y!� ; ` / /(/ 5 <br /> Date Received <br /> Phone Contact for Permittln, — <br /> ( (p <br /> 1 40wners Name mo d/. / ..5 , /7t7 Owner Phone Number cF7 .3 - - '7 ,F - 7 2 se '7' <br /> Owner's Address ,5 0 2 ecl /c �l oy-7 d, (T-7 Owner Phone Number I <br /> Fee Simple Titleholder Name . I Owner Phone Number I <br /> Fee Simple Titleholder Address I <br /> 4 JOB ADDRESS I s ".? f3 /f . Q/� (/-t LOT # I <br /> SUBDIVISION . PARCEL ID#I <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I I SIGN r n DEMOLISH <br /> INSTALL r/1 REPAIR <br /> PROPOSED USE qa SFR [ COMM ' I OTHER <br /> TYPE OF CONSTRUCTION 1 1 BLOCK ri FRAME 1 1 STEEL n f I <br /> 4 DESCRIPTION OF WORK lee r ,1 el 1'7.17 ker I `. < I t C . ,Yl�� <br /> BUILDING SIZE I 1 SQ FOOTAGE' 9oD HEIGHT I <br /> r 1 UILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ?om <br /> r i ELECTRICAL $ AMP SERVICE r PROGRESS ENERGY n W.R.E.C. <br /> 1 IPLUMBING $ <br /> 1 $ VALUATION OF MECHANICAL INSTALLATION <br /> 1-1GAS r] ROOFING n SPECIALTY 1 1 OTHER <br /> FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA I — 1YES NO <br /> BUILDER I vL m-e/2 <br /> SIGNATURE e, REGISTERED I Y/ N I FEE CURREh I Y/ N I <br /> Address I <br /> 1 License # I I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRE1, I Y/ N I <br /> Address I I License # I <br /> PLUMBER COMPANY ' <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREh I Y/ N I • <br /> Address I I License # I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURREt I Y/ N I <br /> Address I <br /> 1 License # I I. <br /> OTHER COMPANY I <br /> SIGNATURE REGISTERED I Y/ N I FEE CURREh I Y/ N I <br /> Address ( 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 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 NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />