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��o-�ex,-�u�u c;ity ot Lephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin �'/,,� � _ ,� <br /> � <br /> Owner's Name /� � Owner Phone Number �J j— ^tj3� <br /> Owner's Addresa � �°r� �j � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS �.j �j ��`f�j �F' � � �/� . <br /> LOT# C� <br /> SUBDIVISION PARCEL ID!! <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED e NEW CONSTR 8 ADD/ALT �� SIGN [� [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE [� SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK /� L� �G` � i r <br /> BUILDIN(3 SIZE SQ FOOTA(3E � <br /> C��v HEIGHT <br /> QBUILDING $ � � y� n� VALUATION OF TOTAL CONSTRUCTION �� °Z� <br /> C/ <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY [� W.R.E.0 <br /> OPLUMBING a <br /> .-� � �`�� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY [—� OTHER �� � G <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> S GNATURE ����-� ,,.--"� COMPANY /`'�/d�J� l�Gv/ff��. <br /> `v'� 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 /> Addresa License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Addreas 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)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 81 dumpster;Site Work Permit for subdivislo�s/large projects <br /> COMMERCIAL Attach(3)comptete sets of BWlding Plans plus a Ufe Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsfte,Constructlon Plans.Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlities 8 1 dumpster.Sfte Work Permit for all new projects.All commercial requirements must meet compUance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '"'"PROPERTY SURVEY requtred for all NEW constructlon. <br /> DirecHons: <br /> Fill out applicatlon completely. <br /> Owner 8 Contractor sign badc of applicatlon,notarized <br /> If over S2S00,a Notice of Commencement is required. (AIC upgrades over i7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone wfth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTfNG (Fmnt of AppllcaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on pubflc roadways..needs ROW ' <br />