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813-780-0020 C:ity ot Lephyrhills Nermit Hpplication rax <br /> Buiiding Department <br /> Date Received , �f phone Contact for Permittln ;� � � � � - S � <br /> Owner's Name �-- iT C F Zc hl� !� i � �S Owner Phone Number '7 �i'o - o c c � <br /> Owner's Address S 33 � ��� " s� � Owner Phone Number <br /> Fee Simpie Titieholder Name �— Owner Phone Number <br /> Fee Simple Tltleholder Address <br /> JOB ADDRESS S $ `� '�' �t�'` S � • � - H � � � LOT # � <br /> SUBDIVISION � . PARCEL ID# � �'� oZ 6 � a �'"' � � ° � ( 3 � � ° � � � � Q <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEw CONSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR � COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME STEEL Q <br /> DESCRIPTION OF WORK �StA (� Nrw t.l)�i ll/C�W �• <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ r��o, '=� VALUATION OF TOTAL CONSTRUCTION <br /> �/ <br /> QELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �� <br /> N �� , �. <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> / gv� <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER -� f[ <br /> FINISHED FLOOR ELEVATtONS FLOOD ZONE AREA QYES NO <br /> BUILDER 1 ,�� COMPANY �b�/ H i�a�J �,o,�,�s�• �'�' <br /> SIGNATURE ��°'� � REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address 3"jC1 �� �� i s /Q � le.0 � � Z' H� M SS License # G6 ��� 77as <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Lice�se # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE __ rte�is�tteo Y/ N FEE CURRE� Y/ N <br /> Address Ucense # �— <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— <br /> RESIDENTIAL Attach (2) Plot Plans; (Z) 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, Constructlon Plans, Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans pius a Llfe Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten (10) working days after submittal date. Required onsfte, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster. Site Woric Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ""«PROPERTY SURVEY required for all NEW construcUon. <br /> Directlons: <br /> Fill out application compietely. <br /> Owner 8 Confractor sign back of applfcatlon, notarized <br /> If over;2500, a Notice of Commencement is required. (A!C 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 /> -, PERMITTING (Front of Application Only) <br /> Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> �ver Counter if on public roadways..needs ROW <br />