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813-780-0020 City ot Lephyrhills Nermit Application rax <br /> Building Department � (/ �SG� <br /> ! � <br /> Date Received '� – 2,j '" � � phone Contact for Permittin – <br /> Owner's Name �� �' Z- '� � Owner Phone Number <br /> Owner's Address ���� �'���`�� ��' e S 1- Owner Phone Number <br /> Fee Simple Titleholder Name r Owner Phone Number ��� — T %'��-� i <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � � C � �� ` � � � S � LOT # � <br /> SUBDIVISION ��'e L°'�'� � �`''�� , ppRCEL ID# 1 '� "�°�_� � '� tl � � ^ � c � � `� � � � � v <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR � ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [� SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ��� � � �- �'� '� � Q� CGCL � �(,��5 � � �{.�. V( jy�,�.�� <br /> J ns�e� <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ �� � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ � U R <br /> �� ��°�, �- <br /> �MECHANICAL $� '� Q U ALUATION OF MECHANICAL INSTALLATION / ''�S, <br /> � � . � � ��/ <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # � � <br /> �, �$ �= f E c� ��- � 4. ��J � C� `�� <br /> ELECTRICIAN r \ COMPANY <br /> �OSIGNATURE ��,� ` � REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address License # �� � 3 o I 2 <br /> MECHANICAL r �� �� COMPANY �.dIP �Uhr l'!�< cf' H�'�A ��c'. <br /> � SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � ' iG � i � / q �� <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permlt for new construction,. <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisions/large prolects <br />