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o,s-��u-w�u �;it� ot Lephyrhills Permit Applicati�n Fax-813-780-0021 <br /> Buflding Department <br /> Date Received G-l� �p� �� <br /> Phone Contact for Permittin Lz Q l� <br /> Owner's Name ��15 Q� Owner Phone INumber <br /> OwnePs Address � /� L� � � a�� Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS v�l f� S'� ��j/`lS /��„ 33� LOT� C� <br /> SUBDIVISION PARCEL ID# ! o�� o�� �� Q��C-'b � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1MORK PROP03ED e NEW CONS7R� ADD/ALT � SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTIOId Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK n � ���/l� e-- QL[ , -2 �p-�� p���S <br /> BUILDING SIZE SQ FOOTAGE C� HEI(3HT � <br /> QBUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a <br /> � ��y <br /> QMECHANICAL $ 38�5 0� VALUATION OF MECHANICAL INSTALLATION �j� <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILOER COMPANY <br /> SIGMIATURE 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 /j��,�., � COMPANY �S R/I/2C�5���-°S/�J e, <br /> SIGNATURE � �"""��� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C�C Q 7 �Q <br /> OTHER COMPANY <br /> SIGfVATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r <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 aRer submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadllUes b 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,Conshuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities�1 dumpster.Site Work Permlt for all new projects.All commercial requirements must meet compBance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •'""PROPERTY SURVEY requlred for all NEW construction. <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Co�tractor sign back of applicatlon,nota►ized <br /> If over 52500,a Notice of Commencement la required. (A/C upgradea 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 AppNcatlon Oniy) <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 />