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°�"-��""""�u C:ity ot Lephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received �y ��� <br /> ` �-- Phone Contact for Permittin 'S�� _ <br /> Owners Name %`�l �C e 1 2 � v�S'� n� Owner Phone Number �S� 3 -3r 2 - ��(�ct� <br /> O�nrner's Address 3 I p 3� eG ''� Owner Phone Number <br /> Fee Simple Titleholder Name - - � Owner Phone Number <br /> Fee Simple Titieholder Address ---_.` <br /> JOB ADDRESS LOT#� �� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> IMORK PROP03ED NEW CONSTR ADD/ALT �, SIGN Q Q DEMOLISH <br /> INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION [� BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK � � <br /> BUILDING SIZE 3Q FOOTAGE o�� ` HEIGHT <br /> C]BUILDING S .y VALUATION OF TOTAL CONSTRUCTION <br /> �� <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING a <br /> � �35°� <br /> QMECHANICAL a VALUATION OF MECHANICAL INSTALLATION � <br /> QGAS Q ROOFING � 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 CURREP Y/N <br /> Address License# �1 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address Ucense# r- <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER " ����� Q�% COMPANY + <br /> SIGNATURE REGISTERED Y/ N FEE CURRE Y <br /> Address o � ,� . License# �.�C -l�S Z <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building 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,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaGlitles 8 1 dumpster;Site Work Permit for subdivislonsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster.Site Work Pe►mit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Eng(neered Plans. <br /> ••'"PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Fili out appl(cation completely. <br /> Owner&Contractor sign back of applicatlon,notarized <br /> If over i2S00,a Notice of Commencement is required. (A/C upgrades over i7500) <br /> '" Agent(for the contractor)or Power of Attomey(for the owner)would be someone wtth 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(PIoUSurvey/Footage) <br /> Oriveways-Not over Counter if on pubiic roadways..needs ROW � <br />