|
813-780-UU20 City ofLepnyrnilis Permit Application rax-rs�s-rrsu-u�ci
<br /> Building Department
<br /> Date Recewed Ii ;.Phone-Contact',for-Permitting
<br /> 6LA.
<br /> Owner's Name L? 10 r D.S. Owner Phone Number ,
<br /> Owiner's Address. �! S� Owner'Phon®Number.
<br /> Fee Slmple:Titleholder"Name-`. " Owner°Ph"one Number`
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS !� G 7 dt ,` /` S PG LOT#
<br /> SUBQIVISION PARCEL-"ID#;
<br /> 1
<br /> .(OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> WORK-PROPOSED NEW CONSTR'._ ' ADD/ALT Q' SIGN ] 0" DEMOLISH
<br /> INSTALL . �, REPAIR
<br /> PROPOSED:USE• - . 0 SFR 0: :-COMM 0 OTHER
<br /> TYPE'OF CONSTRUCTION Q' BLOCK 0 FRAME '" _ " STEEL_";0_
<br /> DESCRIPTION OF WORK /7/l { `C�I Sl r e��" a eJ�; �, �C o,
<br /> 1�"
<br /> BUILDING�6ZE " ' S 1-FOOTAGE _ ate HEIGHT-
<br /> •E
<br /> =BUILDING $� �Q, 9� VALUATION'OF TOTAL CONSTRUCTION
<br /> ELECTRICAL $ AMP SERVICE 0'' PROGRESS ENERGY Q -W.R.E.C.
<br /> =PLUMBING $
<br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> =.GAS ROOFING" .0., SPECIALTY. 0 OTHER
<br /> FINISHED*LOOR ELEVATIONS FLOOD ZONE AREA =YES. NO
<br /> :BUILDER . COMPANY
<br /> SIGNATURE REGISTERED Y'/ N: 'FEE:CURREN
<br /> Addrq'ss --License,#' i
<br /> ELECTRICIAN. ;, :. COIIflPANY
<br /> -'SIGNATURE" REGISTERED I Y/ N " fEE+CURREA':." Y/N
<br /> Address ' License#. '
<br /> PLUMBE,R' "COMPANY;;;
<br /> �IGP1ATU tE`' REGISTERED ,.Y/y"N::' :- : .FEE CURREN.
<br /> Address. :.License"#
<br /> RAECHAtdICAL COMPANY
<br /> SIGNATURE:; . `4 REGISTERED Y/.N
<br /> -.:
<br /> FEE;CURRE� :", : Y./.N :..
<br /> Address=r ,l-F-77777,77 cense.#
<br /> '
<br /> ;`:,:OTHER'::.;•,' �_�': "COMPANY.
<br /> REGISTERED Y/N FEE CURREA` Y/N
<br /> x s'
<br /> Addkes�'.: ,:_ :p:v l "Z `^ l' �'"!/ L'icense'#
<br /> RE"DE T -1 I" 1-' a of En` F'"rips-R O= :Pe t'?`:.",":3 r°`"•SI: �iN�-�i,rI_A,.L.:_,,�,k,i-:"•:,:i:M4.titA�iCm,t.►u�,,(r:-2r�)"�RlotiP.,eris;'•:(2)��etsto�?Bu-ilrJin,g��?a..n"`s;`( )rs,t _:;ergy�µ:"o< ;tea`..�,•Wr ._ rt nl,.#o'r•'rie'wrc,.c on.s uc'ton,,.
<br /> ss slteCoucUon�Plans StorrrwatePlns"i•
<br /> P'
<br /> Slit Fnceinsalletl;-
<br /> vu, r4wdAn. e
<br /> " Sanita�ry�tacilities&1 dumpste�;Sitp FWork PermJt fo"r subdvjiops/latge,projects=:
<br /> :. .;.
<br /> MMERCIAL Attach�t2)complete's'ets of Buililing'Plans"plus a°Life Safeiy'Page;(1)set of Energy Forms.R-O-W Permit fbvnew constructlon.'
<br /> V' - Minimum ten(10)•working days after submittal date. Required onsite,Construction Plans,Stonowater Plans w/Silt Fence,installed,
<br /> Senile Facilitles.8:1 dum ster.Site Wo, Permit f&4lI2neW-0ro'ects.All commercial re uirements-must meet compliance
<br /> ry " P *.. P J q
<br /> }`SLGPl PERMIT "7lttecFi'{��'sets,of;Engiriee e'd?Plans:? ,._ '•: r_::,x.
<br /> PROPERTY SURVEY requir®dfgr.all,NEW,copstructionl.,..,
<br /> '4iDlrectlons:
<br /> -.El tidu:application.completely.
<br /> O_—'&Contrar tor'sign:back of'application,notarized
<br /> If"over., 2500i.a Notice-.nf;Commencement is required. (A/C upgrades over$7500)
<br /> n5► ,_..
<br /> i!lgent(forth'e°contraofoi)torRoWer.of Attorney°(for'the owner)woulii"tie someone with notarized letterfrom owner authorizing same
<br /> '°' OAYER;THE COUNTER PRMIITIFIG ...(copyofcontract.required)
<br /> 'Rerdofs•ifatiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> _. :Drt(reways-Not over Counter if on I)Ublic`roadways:needs R01N
<br />
|