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813-780-0020 City of Lephyrhills Nermit Application rax-t�is-irsu-uu�i <br /> Building Department <br /> Date Received � �' � ' <br /> Phone Contact for Permittin <br /> Owner's Name �N 1(L71-� ��"Tj y Owner Phone Number 34fl ' a 8�' '�T �t �� <br /> Owne�'s Address �'� � 4 A LONDA S7 j��E b G VNt , � 48srb pWner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3$ S 3 l Lh2 y � P j�P� y Q��.LZ 33 � y� LOT # ���. <br /> SUBDIVISION SLt�� �y �Lp w , PARCEL ID# a�' a� � a� ° 01�a - .(�a0 <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 <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK N� c�lJ � <br /> BUILDING SIZE SQ FOOTAGE � HEIGHT � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> [ e�ELECTRICAL $ AMP SERVICE � PROGRESS ENERG�F Q W.R.E.C. <br /> QPLUMBING $ f„l <br /> �� <br /> MECHANICAL � � � <br /> C� $ VALUATION OF MECHANICAL INSTALLATION � <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 CURREP Y/ N <br /> Address ' License # <br /> ELECTRICIAN ��'�' � � �� COMPANY � � �T2 c <br /> 51GNATURE °�� REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ���� /��/ ��� i� ���s �/,� � License # G voo r a c� g <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 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 constructlon, <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Pians w/ Silt Fence installed, <br /> Sanitary FacillUes & 1 dumpster; Site Woiic Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach (3) complete sets of Bullding Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construcGon. <br /> Minimum ten (10) working days after submittal date. Required onsfte, Construction Pians, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpste�. Site Work Pertnit for all new proJects. All commerciai requirements must meet compiiance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW consUucUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Confractor sign back of applicatlon, notarized <br /> If over s2500, a Notice of Commencement is required. (AIC upgrades over s7500) <br /> "' Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER TFIE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />