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s�aaso City ofi Lephyrhills Nermit Application rax <br /> Building Department <br /> Date Recelved Z �--, // phone Contact for Permlttin d r � ��7 -- O p <br /> Owner's Name /�-�� �' s� ��'c'U%� "�l� -�j�✓ � Owner Phone Number ��� 3 c y� � C' ��� <br /> Owner's Address '�� �` !�-1�I /f C�Q' �'� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Pho�e Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS 7�� 3�- � �-L gL��D ZC YQ�ffiL-LS �L � 3 LOT# � <br /> SUBDIVISION � t��� Y'� <<� rti S, PARCEL ID# '# -�'� Z S� Z/'' C/�C� - C%C*C' C- �l -L f 1 <br /> (08TAINED FROM PROPERTY TAX NOTICE) <br /> WORK PRUPOSED B NEW CONSTR ADD/ALT � SIGN � Q DEMOLISH <br /> INSTALL ` REPAIR <br /> PROPOSED USE Q SFR COMM � OTHER , <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �-t f� l'� /� �: G L�� � C/� ��C 6' Cti%�Y <br /> BUILDING SIZE � SQ FOOTAGE � HEIGHT �� <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION �' ��� '�� <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION vj( ` I��� <br /> � � 1 <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO <br /> BUILDER C � � � � �� ` COMPANY G''�'�i IC �v Cc��/S� � ilc��i <br /> SIGNATURE �" / REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ��` N�o�-i�Fn1/�'u� R o�L l� License# C� � C ��� �� _S <br /> ELECTRICIAN � /'� � � COMPANY / �'�"f� � Cl�ec �'r �� <br /> SIGNATURE � v`�' �� REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address �3y / l I T,g ,�{� r�c� r i l�r �� 33Sy Llcense # � C' - ODO /2(0$ <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address l.icense # <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 Permit for new construction,. <br /> Minimum ten (10) working days after submittal date. Required onsite, ConstrucUon Plans, Stormwater Plans w/ Silt Fence installed, <br /> C�nif�ni G�nilitinc A. 1 rl�unnc�nr. Ci�., tnl...L o......s� i.......1..�:.a..:....,.n..........�...,.,.a.. <br />