Laserfiche WebLink
""-�tl1�""`u c:iry ot Lephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � .�� .,� <br /> Phone Contact for Permittin <br /> Owne�'s Name � � � �il�Gr p ��' 7�0 -�l5 <br /> Owner Phone Number � <br /> Owner's Address � 8 u�l( � N�} � p�er Phone Number <br /> Fee Simple Titleholder Name <br /> Owner Phone Number <br /> Fee Simple Titlehoider Address <br /> JOB ADDRESS (l/ �� /1'- j� �� �� �`j1�J�S ���� LOT� �] <br /> SUBDIVISION PARCEL ID# DoZ �(!j o�f D�Q L%� ��Q <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1MORK PROPOSED NEW CONSTR ADD/ALT �� SIGN Q Q DEMOLISH <br /> INSTALL � REPAIR <br /> PROPOSED U3E Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK �!G � q-/�1 L°-Q�[� � a G6m aNe�1IL�5 - LonJC.�n��e,2 f �y <br /> BUILDING SIZE SQ FOOTAGE C] HEIGHT <br /> OBUILDING $ <br /> VALUATiON OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE � PROGRESS EN GY [� W.R.E.C. <br /> QPLUMBING s �r � <br /> ✓ j (% f <br /> MECHANICAL $ �� ��'`,� VALUATION OF MECHANICAL INSTALLATION / <br /> � <br /> OGAS Q ROOFING Q SPECIALTY � OTHER � 1',9�(' � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <br /> BUtLDER COMPANY <br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 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 /> Address License# <br /> MECHANICAL /y„ r,� s �� COMPANY ��f�ie S A�2�S�G° .LN G`' <br /> SIGNATURE «�� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# ei�d ��4�� <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 Permft for new construction, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlides&1 dumpster;Stte Work Pertnit for subdivisionsAarge projects <br /> COMMERCIAI Attach(3)complete sets of Buflding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submfttal date. Required onsite,Construction Plans,Stormwater 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 Engineered Plans. <br /> '"'"PROPERTY SURVEY requlred for all NEW constructton. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applicallon,notarized <br /> If over 52500,a Notice of Commencement is required. (AIC upgradea over 57500) <br /> " Agent(for the conVactor)or Power of Attomey(for the owner)would be someone wtth notarfzed letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application 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 />