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813-780-0020 City of Lepnyrnllls t-'ermlt AppliCatiOn I aA-U '.J-' UV-VVL I Building Department ~'" ~5 L ~ Z ^I-I?~ I Date Received etA Owner's Name Owner's Address Fee Simple Titleholder NamJ DESCRIPTION OF WORK 2 fh r C + LOT # I I PARCELID#I()Z -dCo -~/-()o2o -CO~Oo- onZl1 (OBTAINED FROM PROPERTY TAX NOTICE) D ADD/ALT D SIGN D MOVE D CJ REPAIR D COMM D D FRAME D Up G-rfJOFf -I- tic. RefA/r. BUILDING SIZE I I SQ FOOTAGE I I HEIGHT . I . . . I I I . . . . . . . I . . . . . I I I . . . . I . . I I I . I I . . I I I . . . I I I I . I I I . . ~ . . . . . I I . I . . . . I I I . . . I I I I . I I I . . I . . . . I I . I . . I I . . I . . I . . I I I . . . I . I I . I . . . I I . I I I . I I I I I I I . . I . . I I I I I . JOB ADDRESS SUBDIVISION PROPOSED USE TYPE OF CONSTRUCTION El D D I c5eflll Ce. NEW CONSTR INSTALL SFR BLOCK DEMOLIsH WORK PROPOSED OTHER I I I. I OTHER I STEEL D 1$ :$ (;) / L{ 00111 D PLUMBING $ I" D MECHANICAL 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO '"1111111111111111111'"111..'"1111'"11'.'".'.1.1'.1111..111..111.........,.....,........11....11...11111..........11......1111.11.11..11.11.111111 I VALUATION OF TOTAL CONSTRUCTION eo.J,., ~ r~AM-y~~~~ ~ PROGRESS ENERGY D W.R.E.C. D ~ BUILDING ELECTRICAL VALUATION OF MECHANICAL INSTALLATION "35- pu,:"t. S- &:A.ADO per":, ~. BUILDER I SIGNATURE Address I ELECTRICIAN~~ ~5i SIGNATURE . ~ Address. C?)c:!-C-f<;L.. PLUMBER I SIGNATURE. Address I MECHANICAL I SIGNATURE Address I OTHER I SIGNATURE Address I COMPANY REGISTERED Y/N FEE CURRENT Y/N COMPANY REGISTERED License # ~~~(-1FE~f~~~t'f yft1c- License # I GLI5()()/'3~5 COMPANY REGISTERED Y/N FEE CURRENT Y/N License # COMPANY REGISTERED Y/N FEE CURRENT Y/N License # I COMPANY REGISTERED Y / N FEE CURRENT Y/N License # 111111111' II P' 11111111111111111111111111111111111111111111111111111'11111111111111111" 1111111111111" 111111111111111111111111111111111111111' 1I11 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. --"PROPERTY SURVEY required for all NEW construction. I . I I ~ I I I I I I I I I I I ~ ~ I I I I I I I I I ~ I I I I I I I I . I I I I I I . . I I I I I . I I I I '1 I I I I I I I I I I I I I I I I . I I I I II I I I I I I I I I i II I I I I I I I I I I I I I I I i I I I I I I I i I I I I I I I I-II I I I I I I Ii.. i i i I I I I i I Iii Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Driveways Fences (Plot/Survey/Footage)