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o�3-.ou-w�u c;ity ot Lephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Da.*-'Re�ived <br /> Phone Contact for Permittin <br /> ` -- <br /> Owner's Name <br /> Owner Phone Number <br /> Owner's Addresa ,5 ? / Owner Phone Number —� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRE33 �� <br /> LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �] STEEL [� <br /> DESCRIPTION OF WORK � � �j� <br /> • /'7 <br /> BUILDIN(3 SIZE 3Q FOOTAGE HEI(iHT <br /> QBUILDING a <br /> VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL s � J AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> QPLUMBING s <br /> MECHANICAL � r� ��2 <br /> 0 $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License!� <br /> ELECTRICIAN COMPANY �i /�� � ` L, <br /> SIGNATURE � , �— <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � a 9 License# <br /> PLUMBER COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE RECsISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreaa License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Consfruction Plans,Stormwater Plans w/Silt Fence instailed, <br /> Sanitary Fadlitles d�1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Bufiding Plans plus a Life Safey Page;(1)set of Energy Forms.R-O-W Permit for new constructfon. <br /> Minimum ten(10)working days after submittal date. Required onsRe,Conshuctfon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facifltles 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet�mpliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •"•PROPERTY SURVEY required tor all NEW consUuctlon. <br /> Directions: <br /> Fill out applicatlon completely. <br /> Owner&Contractor sign back of applicatlon,notarized <br /> If over S2S00,a Notice of Commencement is required. (AIC upgradea over:T500) <br /> '• Agent(for fhe conVactor)or Power of Attomey(for tl�e owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppNcaUon Only) <br /> Reroofs it shingles Sewers Service Upgrades A/C Fences(Plof/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />