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813-780-0020 City ot Lephyrhills Nermit Application raX-u,s-�uu-�u�, <br /> Building Department <br /> Date Received ,o� — '� ' phone Contact for Permittin – <br /> Owne�'s Name � �I►/Vp Owner Phone Number 3''/ g�'�! i <br /> � � � <br /> Owner's Address �'S�7 T 'S/ Owner Phone Number <br /> Fea Slmple Titleholder Name � � Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � %�S �������� / / �.7�1� LOT# � <br /> SUBDIVISION � , PARCEL ID# �/ '� � I d�l�"'�/���"��30 <br /> (OBTAINEO FROAA PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR� ADD/ALT � SIGN Q �] DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ��y�e f��l'�G"C (/1.��( /7'��6� �c� � <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT � � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ T� . ����� � <br /> �MECHANICAL $ O� �c 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 FEE CURRE� Y/N <br /> Address ' License# � <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lice�se# � —, <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � <br /> Address License# � � <br /> MECHANICAL COMPANY ���� • �/����C--�� <br /> SIGNATURE REGISTERED N FEE CURRE� N <br /> Address � - �..�d�� �� 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-0-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 Facilities& 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Ufe Safety Page;(1)set of Energy Forms.R-O-W Permit for new wnstruction. <br /> Minimum ten(10)wo►icing 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 requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> �'•*PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Fiil out application completely. <br /> Owner&Confractor sign back of applicaUon,notarized <br /> If over 52500,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 ovmer authori2ing same <br /> OVER THE COUNTER PERMITTING (Front of Appllcation Only) <br /> Reroofs if shingtes Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />