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813-780-0020 City ot Lephyrhills Nermit Application raX-�,:�-��u-uuz� <br /> Building Department <br /> Date Received � Phone Contact for Permittin – <br /> Owner's Name �y �� �� �d � 1 ^� `- Owner Phone Number D � 3 ' 9 i7 – �-�� � <br /> Owner's Address ��� C'� P�y�✓ �� Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number �— <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �Q e �cr/ �I pr' � ,��-- LOT # � <br /> SUBDIVISION �— �- PARCEL ID# ��y 2 � r Zj - O �op _ p p / p_ Q/ Z O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER �.- ���q.., <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q � <br /> DESCRIPTION OF WORK � �p��- �j' i�-W � �!� o h � Gj ,� � G o,-( cr re- '�L <br /> BUILDING SIZE �— � SQ FOOTAGE HEIGHT �� <br /> OBUILDING $ 6� <br /> ��p p VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRiCAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q 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 ' License # � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURRE� Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � —� <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, Construcdon Plans, Stormwater Plans w/ Silt Fence instailed, <br /> Sanitarv Gacilificc R 1.inm..�4e.. Ci�.. �ni...i, o,...,..:a a.._ _..u:..�-:---^---- ------`- <br />