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���-�nu-uu�u c;iry ot Lephyrhills Permit A lication <br /> PP � Fax-813-780.0021 <br /> Building Department <br /> ,� I35� <br /> Date Recefved <br /> Phone Contact for Permittin <br /> Owner's Name <br /> Owner Phone Number <br /> OdvnePs Address J� 3 9 ��� �1�� �------ <br /> Owner Phone Number <br /> Fee Simpie Titleholder Name <br /> Owner Phone Number <br /> Fee 3imple T(tieholder Addresa <br /> JOB ADDRESS /j -^� ��, ���� � <br /> LOT� <br /> SUBDIVISION <br /> PARCEL ID�k <br /> 1MORK PROP03ED e (OBTAINED FROM PROPERTY TAX NOTICE) <br /> NEW CONSTR 8 ADD/ALT � SIGN <br /> INSTALL REPAIR 0 C� DEMOLISH <br /> PROPOSED USE Q SFR Q COMM <br /> TYPE OF CONSTRUCTION [� BLOCK � OTHER <br /> Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK I.v�1�-�,� �,r,7� ,� �� / <br /> JE�. ( '�,� �l.�LCK•cn,/ • <br /> BUILDING SIZE 3Q FOOTAGE <br /> NEIGHT <br /> OBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL $ AMP SERVICE <br /> c+�d�. �c� �] PROGRESS ENERGY [� W.R.E.0 <br /> QPLUMBING $ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA <br /> QYES NO <br /> BUILDER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas <br /> License# <br /> ELECTRICIAN �f�� � � COMPANY <br /> SIGNATURE °�z �% ,.���"�"�""'� REGISTERED <br /> Y/ N FEE CURRE� Y/N <br /> Address ��$3L �v� 2, ���� <br /> License# � <br /> PLUMBER COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURREA Y/N <br /> Address <br /> License# <br /> AAECHANICAL COMPANY <br /> SIGNATURE <br /> 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)Piot Plans;(2)sets of Buildfng Plans;(1)set of Energy Fortns;R-O-W Permit for new construction, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stonnwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles b 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 Permtt for new conshuction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructfon Plans,Stortnwater Plans w/Silt Fence instalted, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all new pro)ects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY requ(red for all NEW construction. <br /> Directions: <br /> Fill out applicatfon completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement Is requtred. (A/C 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 Appllcatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> �►iveways-Not over Counter if on public roadways..needs ROW <br />