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813-780-0020 City ot Lephyrhills Nermit Hppucaiion �2� rax-oio-iou-vvci <br /> Building Departme�t .�12 J <br /> Date Receivec� ' i i�� phone Contact for Permittin V l ��� - 5 7 7� <br /> Owner's Name �...� Q '�jU�.SAI� �}�1�11. Owner Phone Number ? S �� � 35�5 <br /> Owner's Address 3��� ����D �(L�V.�. Owner Phone Number <br /> Fee Simple Titleholder Name ��M£ Owner Phone Number �— � <br /> Fee Simple Titleholder Address ��- <br /> JOB ADDRESS �J7 � w�-�JCs�kl�� �R�V.E LOT # 7 � <br /> SUBDIVISION � �O�fl ��NO� , PARCEL ID# (�'�' Zl� �120 - DOOOrJ � 07'�O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADDlALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL � <br /> DESCRIPTION OF WORK A�D� �A1�1 ��GP��►�. �✓'�O�Nts ��►Q,Qp� � IN�RIPQ, LL(K'oQ-�.'�„S <br /> BUILDING SIZE � X� IYlot� SQ FOOTAGE � 1 g HEIGHT 8��p'�S <br /> [�BUILDING $ ��, `�5, VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ i' ,�,�^ _� AMP SERVICE [�] PROGRESS ENERGY Q W.R.E.C. <br /> c�� r�o� <br /> �PLUMBING $ `, �� p � QO � �� � <br /> � �-� 1 C� ►� � 1��✓ <br /> �MECHANICAL $� VALUATION OF MECHANICAL INSTALLATION L�,"�`P s�Y�`" <br /> � <br /> l � U� <br /> OGAS � ROOFING Q SPECIALTY � OTHER 3� � P <br /> FINISHED FLOOR ELEVATIONS Ago��, ��t.o,,,J�.1 FLOOD ZONE AREA QYES NO �`'� J <br /> O oq u <br /> BUILDER �� � COMPANY � M,�cl� CE�S"S'WI�.TOI� y�NZ, <br /> SIGNATURE REGISTERED / N FEE CURRE� Y/ N <br /> Address ��J' J�� �£.Ql1 (W11.�,5 �y,., 3'a'S�1 License #��s�, �� 1 � <br /> ELECTRICIAN �( �1 �O COMPANY GHST �A�� G�-��R�C <br /> SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ( ��- �.�- �-fl G� � License # E< < 300 30�� <br /> PLUMBER /� -(��,,., ' � �%� COMPANY ��N�'S W��A!'J45 ��M.4111C+ <br /> SIGNATURE o��"h"�'� ��..1.,-l� ��.'..w- REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address -$�X �3g Z� 33.539 License # �C- �'�' � � Z- <br /> MECHANICAL ` �' �' COMPANY �R-cS C��S � (� �.. <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � �-� �4� �',YJ � �S� � Ucense # �� � 8 <br /> OTHER �n COMPANY <br /> SIGNATURE In� REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address �'I�G j ���U� <br /> Ucense # <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Pla�s; (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 w/ Silt Fence installed, <br /> Sanitary Facilttles & 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 Forms. R-O-W Permit for new consUuction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requlrements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ""'PROPERTY SURVEY requlred for all NEW construcUon. <br /> �a - nTii�r��rr������������� <br /> Directions. "'" "''�'" ' a '�� � � �� <br /> Fill out application completely. <br /> Owner & Confractor sign back of applicatlon, notarized <br /> If over s2500, a Notice of Commencement is requlred. (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 /> 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 />