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813 -780 -0020 City of Lephyrhills Hermit Application rax- t373- iau -uuz, <br /> Building Department 4 4 // ( , ( 75 <br /> I% Date ceived. Phone Contact for Permittin, — <br /> Owner's Name rt •1L 1.`� a - 1 _ / Owner Phone Number / <br /> Owner's Address 1 38 b / 4 V l.. t 'U"---* Owner Phone Number I ,S — <br /> Fee Simple Titleholder Name . Owner Phone Number I <br /> Fee Simple Titleholder Address I <br /> JOB ADDRESS WC 7 I LOT # 1 I <br /> SUBDIVISION C4-0 r, g— — 2- 4 1 4 1 . PARCEL ID #I V 1 — 2(5-21 * 0010- 137a°- ool.!? <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR i� ADD /ALT I 1 SIGN [l n DEMOLISH <br /> INSTALL I. REPAIR <br /> PROPOSED USE I SFR [] COMM m OTHER 1 I <br /> TYPE OF CONSTRUCTION [ BLOCK Q FRAME I I STEEL El I I <br /> DESCRIPTION OF WORK - is '. 2-- - I - sized" -_sr / SS,/ -dt-e-- -- lr—f`t., 'rk- <br /> BUILDING SIZE I Cr % SQ FOOTAGE' , HEIGHT I <br /> r BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> I (ELECTRICAL $ AMP SERVICE [ PROGRESS ENERGY [l W.R.E.C. <br /> 1 'PLUMBING $ <br /> j5ZIMECHANICAL $ c.y� VALUATION OF MECHANICAL INSTALLATION <br /> ']GAS [] ROOFING n SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [ NO <br /> BUILDER COMPANY I <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURREP 1 Y/ N I <br /> Address I 1 License # I J <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREt' 1 Y/ N 1 <br /> Address I I License # I <br /> PLUMBER COMPANY I <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURREh 1 Y/ N 1 <br /> Address I 1 License # I <br /> MECHANICAL /J 9j �l COMPANY I �'Ac F WAG ` - 1 <br /> SIGNATURE L.4 CO ISTERED 1 Y / N I FEE CURREI. y�, Y / <br /> 1 N <br /> Address 1 - 26 - d (� s` f �. N P r ei 1 License # I C'/t�C.� /, l rses <br /> OTHER COMPANY I <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURREA I Y/ N <br /> Address I 1 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 /> .{ wner & Contractor sign back of application, notarized <br /> 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 /> • <br /> ' <br />