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o is-iov-uu�� c;ity ot Lephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> D�te Received <br /> Phone CoMact fo�Permittin _ <br /> Owner's Name D��/�7 //V ,�/V pyvner Phone Number d��"'7a ���� <br /> Owner's Addresa p �L� Owner Phone Number <br /> Fee Simple Titieholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��� T��� G !� /�/�j��L.�.� ��.✓ LOT# C� <br /> SUBDMSION /G�� / PARCEL ID* ��"-�� ��/-D�OD GbGY.� Ul3L� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B N�nr coNSTa�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 Q <br /> DESCRIPTION OF WORK �C � FJ - 'du_'� � e 7y p�fP_ � <br /> BUILDING SIZE SQ FOOTAGE� HEIt3HT <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL a AMP SERVICE Q PROGRESS8'"�ENERGY <br /> Q W.R.E.0 <br /> OPIUMBING a f / � �� <br /> / . <br /> MECHANICAL � � <br /> 0 3 ��0, ,y,� VALUATION OF MECHANICAL INSTALLA�ION , <br /> v�� <br /> OGAS Q ROOFING [] 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 <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# -1 <br /> MECHANICAL /y��� ��' COMPANY �X/�S j'��/���57�'� � �jL.-� � <br /> SIGNATURE G��� REC�ISTERED Y/ N FEE CURRE� Y/N ' <br /> Address License# �rJ C%Q 'j�,3�'j�g <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Addresa License# <br /> RESIDENTIAL Athach(2)Plot Plans;(2)sets of Buflding 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 Fadlitles 8 1 dumpster,Stte Work Pertnit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Buflding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constn�crion. <br /> Minimum ten(10)working daya aRer submittal date. Requt�ed 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 /> Fill out applicatlon completely. <br /> Owner 8 Co�tractor sign badc of applicadon,notarized <br /> If over i2S00,a Notice of Commencement is requlrod. (AIC 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 PERMI7TING (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers ��rvice Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubNc roadways..needs ROW , <br />