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�„-�aW�,uzu Lity ot Lephyrhills Permit Appiicat�on -ax_�R�_���_��;- <br /> Building Department <br /> Date Received Phons Contact for Pertnittin -- <br /> OWVner's Name Owner Phone Number `___ <br /> Owvner's Address Owner Phone Number ____ � <br /> Fee Simple Titleholder Name � Owner Phone Number � <br /> Fee Simple Titleholder Address � <br /> ,108 ADDRESS LOT# �] <br /> SUBDIVISION �— � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> �MORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> '1fYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDIN(3 SIZE �—� sQ FOOTAGE� HEIGHT �— <br /> QBUILDING � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL '� AMP SERVICE � PROGRESS ENERGY Q W.R.E.0 <br /> OPLUMBING a <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �GAS 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 /> Address License# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# � <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y I N <br /> Address License# <br /> MIECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> License# <br /> Addross <br /> RESIDENTIAI. Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new consVuction, <br /> Minimum ten(10)working days after submittal data. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Bullding Plans plus a Life Safety Page;(7)set of Energy Forms.R-O-W Permit for new consiructfon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles 8 1 dumpster.Site Work Permit for all new projects.Ali commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ••""PROPERTY SURVEY requfred for all NEW constructlon. <br /> Directions: <br /> Fill out application completeiy. <br /> Ovmer&Contractor sfgn back of applicatlon,nota�ized <br /> If over 52500,a Notice of Commencement ia required. (A/C upgrades over E7500) <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 PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades AIC Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />