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813-780-0020 Gity ot Lephyrhills t�ermit Application rax <br /> Building Department <br /> . � <br /> Date Recefved "� �8t f � <br /> Phone Contact for Permlttln _ <br /> Owner's Name � ..� Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simpie Titleholder Name Owner Phone Number �- -� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �3 �I � 1� t �•- LOT #�� <br /> SUBDIVISION � � , PARCEL ID# � D � iZb " :�-� O� � (� • �{p • � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR`�] ADD/ALT [� SIGN Q Q DEMOLISH <br /> INSTALL Q REPAIR <br /> PROPOSED USE Q SFR � COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK FRAME � STEEL Q <br /> DESCRIPTION OF WORK R v «.� + <br /> BUILDING SIZE � SQ FOOTAGE �] HEIGHT <br /> QBUILDING �� VALUATION OF TOTAL CONSTRUCTION <br /> Q�LECTRICAL $' u � , v � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> _` <br /> QPLUMBING $ <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 PEE CuRRE� Y/ N <br /> Address ' License # <br /> ELECTRICIAN (� COMPANY ��.`p1 � X�'e �• G�•- <br /> SIGNATURE � yJ� REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address �'C�?���C�� <br /> License # <br /> PLUMBER COMPANY <br /> SIGNATURE _ REGIS7ERe� 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 Ucense # <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new constructton,. <br /> Minimum ten (10) 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 subdivisionsAarge projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten (10) worlcing days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilitles & 1 dump�ter. Ske 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 construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 ConFractor sign back of application, notarized <br /> If over;2500, a Notice of Commencement Is required. (AIC upgrades over;7500) <br /> " Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TING (Front of AppUcatlon Onty) <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 />