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��o-r�u-uuzu City of Lephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received ~ ?j `� ` Phone Contact for Permittln �� G� -- �4 � <br /> Owner's Name. W��w��/ �,, .� �"low. {�►�I uw+a� Owner Phone Number _ <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number �— � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 7 �/i A LOT # � <br /> SUBDIVISION �+� T�r ( r PARCEL ID# J 7'��^ Z -� 0 0 0� 0 p .. d 0 D O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN � 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTIONOFWORK (.�i�ou f• riw��.�. Iitc �ir Ii c^ �d N1�7���II " <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT <br /> �BUILDING $?! VALUATION OF TOTAL CONSTRUCTION <br /> >7 <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY 0 W.R.E.C. <br /> �PLUMBING $ �}' (��V`� <br /> �' � <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � <br /> OGAS 0 ROOFING Q SPECIALTY 0 OTHER �✓ � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY ' �d,s,/ �Ci � a � �q iJ � <br /> SIGNATURE REGISTERED Y N FEE CURRE� / N <br /> Address 0 li��fini�',� �� - License# ��G �sO 9 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <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 construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8� 1 dumpster; Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach (3) complele 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) working days after submittal date. Required onsite, Construction Pla�s, Stormwater Pians w/ Silk Fence installed, <br /> Sanitary Facilities 8 1 dumpster. Site Work Pe�mit for all new projects. All commercial requirements must meel compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> """PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (A/C upgrades over 57500) <br /> " Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner auihorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />