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"„-'°u-u�'�u C:iry ot Lephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin __ <br /> Owner's Name �E1�.E,`C� �'� }-� Owner Phone Number <br /> Ovuner's Address fp� � � -�- �.. � �],�- Owner phone Number � � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> J08 ADDRESS �1�-t r � - �✓ LOT# �� <br /> SUBDIVISION PARCEL ID�! CU3 Z" -- t � . � OOC�O i Z U <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT �] SIGN Q Q DEMOLISH <br /> INSTALI REPAIR <br /> PROPOSED USE Q SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �] STEEL Q <br /> DESCRIPTION OF WORK r �- <br /> BUILDING SIZE SQ FOOTAGE 3� HEIGHT <br /> QBUILDING $ � VALUATION OF TOTAL CONSTRUCTION <br /> i <br /> QELECTRICAL � AMP SERVICE Q PROGRESS�E�3.6�-•-��] W.R.E.0 <br /> QPLUMBING a f'" � <br /> �� � � y� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTAILATION � <br /> r f'' <br /> . �� <br /> OGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER �� COMPANY Gc.0 I ���� ;E�✓ IC�Cg� i� <br /> SIGNATURE REGISTERED Y/ N FEE CURR � Y/N <br /> Address 1 4 Gt C���� �,�,cZ ,Y 1• \� � � �v`{� License# �1�. <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURREP Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE 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 Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submlttal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlftles d�1 dumpster;Site Work Pem►it 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)woricing days after submittal date. Required onsite,Conshuctlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> '"'"PROPERTY SURVEY required for all NEW consUuctlon. <br /> Directlons: <br /> Fill out application completely. ?� h <br /> Owner&Contractor sign back o pplicatlon,notarized <br /> If over 52500,a Notice oi Com�e�cement Is requi►ed. {A!C upgradea over�1500) ' '"''"�'°^ <br /> " Agent(for the contractor)or Po r�df Atbomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTIN (Front of�Appflc�tltin Only) <br /> Reroofs if shingles Sewers �Plot/Surv�(Footage) <br /> -�-�-�,_�,r.._ :,:.. <br /> ,,�..,�,;.,.�,;��„,�.•s...,,,�..-:re�"°�.,. <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />