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oia-rau-uu�u �;iry oi Lephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received �-. �� ^ _-�� <br /> Phone CoMact tor Permfttin � <br /> Owner's Name r'1'LF � S f`(1 ��` , l Owner Phone Number • �� .Q�� <br /> Owner's Address l.¢ � � �� � f- �S�-( pwner Phone Number <br /> Fee Simpie Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRE3S I�C� �� � c LOT* �� <br /> � • <br /> SUBDIVISION �JL� � PARCEL IDN � . a •C�I o(�. �Tj�j� • �7a�C j <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED B NSTALLSTR 8 REPAIR � �G(�. O CI DEMOLISH <br /> PROPOSED USE �' SFR Q COMM �] OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �-'f � i ' �� � <br /> BUILDINt3 SIZE SQ FOOTAGE� HEICiHT <br /> �UILDING �� _ VALUATION OF TOTAL CONSTRUCTION <br /> �]ELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING s �i 3 a� <br /> � <br /> QMECHANICAL � VALUATION OF MECHANICAL INSTALLATION <br /> [�GAS � ROOFING Q SPECIALTY �] OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y J N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r <br /> PLUMBER COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lic:ense# <br /> OTHER COMPANY r x{ <br /> SIGNATURE REGISTERED Y/ N FEE CUR Y/N <br /> Address �-( � �-J � c t� License# 1��� �� <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)worlcing days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Fadlldes 8 1 dumpster;Site 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 Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construcrion Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster.Site Woric Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Atfach(2)sets of Engineered Plans. <br /> '"""PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Fill out applicatlon completely. <br /> Owner 8 Contractor sign back of applicadon,notaMzed <br /> If over i2S00,a Notice of Commencement is requlred. (AIC upgradea over s7500) <br /> •' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with nota�ized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppllcaUon Only) <br /> Reroofs ii shingles Sewers Service Upgrades A/C Fences(Plof/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />