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o i�-iou-wcu c;ity oT Lephyrhills Permit Application Fax-813-780-0021 <br /> Buiidfng Department <br /> Date��Aceived � ��� � _. �/� <br /> Phone Contact for Permittin <br /> Owner's Name �. Owner Phone Number ��3 3/ Z 17',� <br /> Owner•s Address � �S� �Q � Owner Phone Numbe� �- -� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS ��� S � G�/`{ Ti� � 1 5 3 3 S�f O LOT� C] <br /> SUBDMSION PARCEL ID�! <br /> �OBTAINED F�pROPERTY TO ricE)DEMOLISH <br /> WORK PROPOSED B NEW C�NS7R ADD/ALT �, SIGN <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q (-- <br /> DESCRIPTION OF WORK �/� S� C�,By1,pQp�X[.�iJ. �� ��/�,w� , 3,� ,7 <br /> J <br /> BUILDIN(i SIZE SQ FOOTAGE� HEICiHT <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL a AMP SERVICE Q PROGRESS Ey+tRGY' 0� W.R.E.0 <br /> / <br /> QPLUMBING a � <br /> •,� � 6 <br /> �MECHANICAL $ n� p�p VALUATION OF MECHANICAL INSTALLA �� �A <br /> r" ��/� • ----' TIO �� <br /> / �ft , ! <br /> OGAS [] ROOFING [] SPECIALTY � OTHER � / <br /> FINISHED FLOOR EL�VATIONS FLOOD ZONE AREA QYES � NO <br /> . <br /> BUtLDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License# <br /> ELECTRICIAN COMPANY <br /> $IGNATURE 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 ' � CCJ'�� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �s�?3 �}� ��. <br /> License# ���C���.3 <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREO 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 PeRnft for new construction, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles d�1 dumpster;Stte Work Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertn(t for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructfon Plans,Stormwater Plans w/Silt Fence installed. <br /> Sanitary Facflities d�1 dumpster.Site Wor1c Permit for all new pro�ects.All commercial requirements must meet comptiance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY requlred for all NEW constructlon. <br /> Directlons: <br /> Fill out applicatlon completely. <br /> Owner&Contractor sign badc of applicatlon,notarized <br /> If over 52500,a Notice of Commencement is roquired. (AIC upgradea over 57500) <br /> " Agent(for the contractor)or Power of ABomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTfNG • (Front of AppOcaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter it on public roadways..needs ROW , <br />