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s�3-7so-oozo City ofi Lephyrhills Nermit Application tax-tS13-/1iU-UU'L1 <br /> �Bui�I�fIQ�e�ftrflP�flt <br /> � s r <br /> N�� �� <br /> Date Keceiveci� Phone C act for Parmittin - <br /> Owner's Name L.f�P �C ll0l(J /uOy�L� Owner Phone Number ,3^7�.Z' Il�l <br /> Ow�er's Address 3� ,2� �.ANS!/✓�G A✓k Owner Phone Number <br /> Fee Simple Titleholder Name —� Owner Phone Number r— � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �I,E LOT# � <br /> SUBDIVISION � , PARCEL ID# 4.� ^z�O -'?l^ Q�60 - OODUO- O/P�]Q <br /> (OBTAINED FROMI PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR� ADD/ALT [�� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME [� STEEL Q <br /> DESCRIPTION OF WORK � �C� <br /> , i GNTf-� <br /> w• _s .� <br /> BUILDING SIZE —] SQ FOOTAGE� HEIGHT �Q�C� �� <br /> �BUILDING $ <br /> � �. VALUATION OF TOTAL CONSTRUCTION U1�yG <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY <br /> Q W.R.E.C. <br /> ��QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � � �� � <br /> QGAS Q ROOFING Q SPECIALTY �,� OTHER ��� <br /> FINISHED FLOOR ELEVATIONS � <br /> FLOOD ZONE AREA QYES O <br /> BUILDER �"J COMPANY Gf//!� I�LCt�lrJ�-°��jQ Pr-�' I� <br /> SIGNATURE P ed' � e �.oceJ �GISTERED Y/ N E CURRE� Y/N <br /> Address � / ,v � <br /> License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N � <br /> Address License# �— � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> Ucense# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> Llcense# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon 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 Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permft for new construcGon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&7 dumpste�.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""*PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Confractor sign back of applicaUon,notarized <br /> If over 52500,a Notice of Commencement is required. (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 Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />