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813-780-0020 City ot Lephyrhills Nermit ApplicaUon ^� , raX-�,s-�au-uun <br /> Building Department � II��1 <br /> Date Received Phooe Contact for Permittin �� � ���� -�--� L <br /> Owner's Name W�S% !�✓�N� G f Owner Phone Number <br /> Owner's Address ��/ �/L � /�L r/!� Owner Phone Number <br /> Fee Slmple Titleholder Name � Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � —l /�'( �-�J LOT# � <br /> SUBDIVISION . PARCEL ID# �:3 ��+ v��UGY U'US 3UV '�U� � <br /> (OBTAINED FROM PROPERTY TAX NOTICEj <br /> WORK PROPOSED � NEW CONSTR B ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �o ! �C� FG�/✓ �% <br /> BUILDING SIZE SQ FOOTAGE � FT HEIGHT ro � <br /> �]BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> S'O_6 0 <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING �$ � � � �1 �� <br /> L �j r, <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY �/�/9SCv ��/�C°� �-'U ��/C' <br /> SIGNATURE REGISTEREO N FEE CURRE� N <br /> Address "L C���-� S"— Z ' ` � Llcense# <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 CURREA Y/N <br /> Address Llcense# � � <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 E�ergy Forms;R-O-W Permit for new construction,. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Sitt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permlt for subdivlsions/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 construction. <br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Construction Plans.Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facillties&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 construction. <br /> Dlrections: <br /> Fill out application completely. <br /> Owner 8�Confractor sign back of appllcation,notarized <br /> If over$2500,a Notice of Commencement is required. (A!C upgrades over;7500) <br /> *" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authoriiing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades AIC Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />