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o�„-,o�,-�,u�u L:ity oT Lephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � — � � Phone Contact for Permittin �� 3 7o a' � 3 r3 r <br /> Owne�'s Name � � Owner Phone Number <br /> Oevners Addresa ��� �(�D �' �� Owner Phone Number <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> Fee Simple Titleholder Addross <br /> JOB ADDRESS � LOT* C� <br /> SUBDIVISION PARCEL ID# �2 -�'� 2'( � ��� �O� �C�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> MMORK PROPOSED B NEw CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> D�SCRIPTION OF WORK , � /S�� ' ��� <br /> BUILDING 31ZE 3Q FOOTAGE�� HEIGHT <br /> OBUILDING � � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL � I�Q� CJi) AMP SERVICE��tj [� PROGRESS ENERGY Q W.R.E.C. <br /> ��`�- 1N�'�K98 <br /> �PLUMBING S <br /> � � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I� � <br /> / <br /> �GAS Q ROOFING Q SPECIALTY Q 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 r COMPANY �' �p2� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �e O���-Z� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> IVIECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED 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 Pertnit for new consWction, <br /> Minimum ten(10)virorking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflitles b 1 dumpster;Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safely Page;(1)set of Energy Forms.R-O-W Permit for new conshuction. <br /> Minimum ten(10)wotking days after submittai date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadflties 8�1 dumpster.Site Work Permit for all new proJects.All commerciat requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ••"•PROPERTY SURVEY requfred for all NEW constructlon. <br /> ....�����rr*�rt„��„'1 <br /> Diroctions: <br /> Fili out applicatlon completely. <br /> Owner 8 Contractor sign back of applicaHon,notarized <br /> If over i2500,a Notice of Commencement Is required. (AIC upgrades over 57500) <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 ApplicaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />