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813 - 780 -0020 City of Lephyrhills Permit Application rax -61 - nw -uuz <br /> Budding Department <br /> Date Received ■ 1 <br /> Phone Contact for Permittin, <br /> Owner's Name C ha R.4.€ s P I?GC -t° Owner Phone Number a 13 - no- i ss <br /> Owner's Address I 5s ° SI 51 , I Owner Phone Number I 13 - q 9 -7 - a b <br /> Fee Simple Titleholder Name . I I Owner Phone Number I <br /> Fee Simple Titleholder Address I <br /> JOB ADDRESS I 5sa`'l Is-r/' sr , <br /> I LOT # I <br /> SUBDIVISION I 1 , PARCEL ID #I ( ( - OA -- ? / - 0°4 a - Comic-' a <br /> (OBTAINED FROM PROPERTY TAX <br /> WORK PROPOSED I I NEW CONSTR ADD /ALT I I SIGN [J I VI DEMOLISH <br /> INSTALL F REPAIR <br /> PROPOSED USE n SFR n COMM I I OTHER I <br /> TYPE OF CONSTRUCTION n BLOCK Q FRAME I <br /> STE EL n I I <br /> DESCRIPTION OF WORK 1 R - -. s }'►.mod , & ii(o <br /> I <br /> BUILDING SIZE I J SQ FOOTAGE' 1 HEIGHT I I <br /> I BUILDING <br /> J I $ <br /> A o D v VALUATION OF TOTAL CONSTRUCTION <br /> nELECTRICAL Is I AMP SERVICE n PROGRESS ENERGY <br /> I 'PLUMBING I$ I <br /> 7v nMECHANICAL $ i VALUATION OF MECHANICAL INSTALLATION � / <br /> n GAS n ROOFING '] SPECIALTY I I OTHER ( j 61 FINISHED FLOOR ELEVATIONS I I n FLOOD ZONE AREA YES NO <br /> BUILDER COMPANY �ki <br /> SIGNATURE % 'Lfj F.,46:), I CO 1 K F= • i (rte a �N R�iC'f'i c ry ZNC I <br /> !f// REGISTERED (1, N I FEE CURREN I I <br /> Address I I I <br /> License # I <br /> ELECTRICIAN I COMPANY I <br /> SIGNATURE I REGISTERED I <br /> I Y/ N I FEE CURREN I Y/ N I <br /> Address I I <br /> License # I <br /> PLUMBER COMPANY I <br /> SIGNATURE I REGISTERED I <br /> I I Y / N I FEE CURREN I Y/ N I. <br /> Address I I <br /> License # I <br /> MECHANICAL I COMPANY I <br /> SIGNATURE I I <br /> REGISTERED I Y/ N I FEE CURREN I Y/ N I <br /> Address I 1 <br /> License # I I <br /> OTHER COMPANY I <br /> SIGNATURE <br /> REGISTERED I Y/ N I FEE CURREN I Y/ N I I <br /> Address I 1 <br /> Ucense # 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 Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> 3VER THE COUNTER PERMITTING (Front of Application Only) <br /> 2eroofs if shingles Sewers Service Upgrades NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />