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813-780-0020 City of Lephyrhills Nermit Application rax-uis-iau-uu�i <br /> Buitding Department <br /> Date Received � <br /> r0 r � Phone Contact for Permittin ��.� ��Z -3,3� j <br /> Owner's Name -SH / c Lt YO p. ff� Owner Phone Number .1 -,y 1� <br /> Owner's Address SS e20 � n y� t�'c S�. G��/�vr /i'� ���� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �S�ir! e LOT # �� <br /> SUBDIVISION �— �'I "-Z� ' <br /> . PARCEL ID# .2 /-� �,B - oo S�- o 0 o D <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISN <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK I� /� c c,Serv�< <�iv �i�fnc e`{o�t a�n�? iN�er�.r a�. `/ <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ � AMP SERVICE �, PROGRESS ENERGY [� W.R.E.C. <br /> S' � /00 A �.- <br /> QPLUMBING $ <br /> � � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLAT N ,�I f�� <br /> / <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES � f � <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address ' License # <br /> ELECTRICIAN ' I r� p COMPANY �����C C�« ���c <br /> SIGNATURE �/��r�'� REGISTERED Y/ N FEE CURRE� N <br /> Address 39��/ A�i��� Ze �/i F/- ,3,3�y ya License # EC pd01 z G 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 Ucense # � <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 (70) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Fonns. R-O-W Permit for new construction. <br /> Minimum ten (10) woricing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence lnstalled, <br /> Sanitary Facilitles 8 1 dumpster. Site Work 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 constructlon. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Confractor sign back of application, notarized <br /> If over s2500, a Notice of Commencement is required. (A/C upgrades over;7500) <br /> " Agent (for the contractor) or Power of Attomey (for the owner) wouid be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppUcation 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 />