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�,�-,o�,�u L�ty ot Lephyrhitls Permit Application Fax-813-780-4G21 <br /> BuNding Department <br /> .te Recefvec! Phone Contact for PsrmiHtln ��.�. ��~� — '"��4�� � <br /> mer's Nams � h �'�1LL5 G-/��nt.3 t�O112 ��Owner Pltane Number O/v�°" �cs �°-1�� <br /> rner's Address �1J� �� E � Owner Phone Number <br /> e Simpie Tftlehatder Name � � Owner Phone Number <br /> e Simpie Titiehoider Address <br /> �BAbDRESB ✓ � `JSJ�C� � �' 47Uti LQT# [�� <br /> �BOivisioN �� � PARCEL ID# /.1� r�.(,�,z .�/ �G?l ll>iLsD ��d <br /> (OBTAINEp FROM PROPERTY TAX MOTICE� <br /> �RK PRdPb3ED e NEW CON5TR� ADQtA�T �� SIGN Q Q DEMGILISH <br /> IRIS1`ALL f2EPA1R <br /> :OPOSED USE [� SFR Q COMM [,� OTHER <br /> PE!?F CONSTRUC7lON Q B�OCK C] FRAME [� STEEL Q <br /> ;3CRIPTION OF WORK - � 1 C?'71.) � /�" � <br /> �ILdINCa SIZE � � S4 FOOTAGE�_�__� HEIGHT [�_� <br /> OBUlLDING r�� VALUATION OF TOTAL CdNSTRUCTION <br /> L <br /> QELECTRICAL � � AMP SERVICE Q PROGRESS ENERGY [_] W.R.E.C. <br /> QPIUMBING �� <br /> �MECHANICAL $ y/�Q��� VALUAT�ON OF MECHANICAL INSTALLA710N <br /> '7 ! <br /> [�GAS [� ROOFt(3G Q SPECIAL"t'Y [� OTHER <br /> NSNED FLOOR ELEVATIQNS �� F�OQD ZORfE AREA QYES NO <br /> 1LDER COMPANY <br /> iNATURE REGI&TEREO Y! �i FEE CURRE� Y/N <br /> Addrass License# � � <br /> �CTRICIdN � � COMPANY <br /> �NATURE REGISTEREO Y/ N FEE CURREM1 Y/id <br /> Address License# �'�� � <br /> 1MBER � COMPANY <br /> �NATURE REGISTEREO Y/ N FE�GURRE� Y!N <br /> Address License# �— � <br /> CHANICAi. �(.G•Y1'� `Y—�1��t.(3.�','rtR.�.., COMPANY ��J��'`r. !�'d,o�IIJ�.° �� 9Z �}'fe, �.—?�,n/�, <br /> NATURE � REGISTEREO Y/ N hEE CURRE►� Y/N <br /> Address License# ���,'7 ,� g r�� <br /> !ER COMPANY <br /> NATURE REGISTERED Y/ N FEE CURREt� Y/IV <br /> Address L(censs# �` `� <br /> iIDENTiAL Attach{2)Plot plans;(2)sets af Building Plans;(4)set af Energy Forms;F2-t3-W Permit far new construction, <br /> Minimum ten(1Q)warking days a8er submittai date. Required ansite,Canstruction Ptans,Stormwater Plans w/Stlt Fence tnstalled, <br /> Sanitary Facilitles&1 dumpster;Site Work Permit far subdivisfonsliarge projects <br /> AMERCIAI. Attach(3)complete seis of Building Ptans plus a Lffe Safety Page;(1)set of Energy Fortns.R-O-W Permit for new conshuotlan. <br /> Minimum ien{1 Q}workfng days after submittal date. Required onsite,Constructian Ntans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facliities&1 dnmpster.Site Wark Permit for ail new proJects.All commercial requirements must meet compUance <br /> N PERMlT Attach(2)sets of Engirteered Pians. ° <br /> ""'PROPERIY SURVEY required for ati NEW constructlon. <br /> ctlo»s: <br /> Fi!!out applfcadon camptetefy. <br /> Ownec&Contractor stgn back of application,notarized <br /> if over�2508,a Notice of Commencement is requlred. (MC upgrades over�7540) � <br /> Agent{for the contractor)or Pawer of Attomey(far the oumer)wauld be someone with rtatarized}etter fmm owner authorizing.same�,^�, . � <br /> iR THE CQUNTETt PERMtTTiNG (Front af Apptication Oniy} ' • � �'` �� ' , <br /> �afs if shingies Sewers Service Upgrades AiC Fences(PIoUSurvey/Footage) ��� �• � � , " . " <br /> Drivaways,Not over Gaunter if an pubtic roadways..needs ROW -• �'-.` ' ' - `�.." -"" -. .`-.•.. ,." <br />