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813-780-0020 City ot Lephyrhills t'ermit Application raX <br /> � Building Department �� 3 _ .� � y _ � 7 � <br /> Date Received � 2�l/ Phone Contact for Permittin — <br /> Owner's Name L�/J'� C�T � I fD f'P /. �; Owner Phone Number /�3 / �`' � � <br /> 3�� � �. - . � p�,��_ C:+a� S/3 ���—� 9� � 9 <br /> Owner's Address '� i / �. -ewr�er Phone Number <br /> Fee Simple Titleholder Name Owner Phona Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS C I �� �1 V IA JC ^�� ��lht L° � S vYA' LOT # � <br /> SL8BFW919N �'� � �%LGfi��� , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK ^ d.t��li ���//� , � ' � <br /> 'E31��p1� SIZE V� � SQ FOOTAGE �O HEIGHT � <br /> ! � � ✓ <br /> �BUILDING $ �Q VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� , <br /> /� �� <br /> QGAS � ROOFING Q SPECIALTY Q OTHER ��/ <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/ N <br /> Address ' Llcense # � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE 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 # <br /> MECHANICAL �OMPANY <br /> SIGNATURE � GISTERED Y/ N FEE CURRE� Y/ N <br /> Address � Llcense # � <br /> OTHER COMPANY � C �� <br /> U!`f On � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address - t— License # C �l� � !� � �' <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, ConstrucUon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilltles 8 1 dumpster; Site Work Permit for subdivisions/lar9e oroiects <br />