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<br />813-780-0020
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<br />City ot LepnyrnIIIs permit AppllcaIlon I "A-U ,,,-, UV.VVL I
<br />Building Department --:r;;;h ("\ z..s L --'t z ^I-I '3'7' I
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<br />Owner's Name
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<br />a.. V'\
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<br />Date Rec.elved
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<br />Owner's Address
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<br />Fee Simple Titleholder NamJ
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<br />2 fh V' C +
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<br />PARCEL ID#I02- -dCo -~ ( - 002.0 - ro<::::OO - DO 2./
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR E3 AD DIAL T D SIGN D MOVE D DEMOLIsH
<br />D INSTALL REPAIR
<br />PROPOSED USE D SFR 0 COMM D OTHER I : .
<br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I .
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<br />DESCRIPTIONOFWORK I [;e"-III(e. Uo (;-ifJOF.( -I- (Ie. Reffl/r. I
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<br />BUILDING SIZE I ! sa ;OOTAGE I I.. H~.I~':':'..!....",..."".""..!,,,.,,,,,,..,,,,,,,,,, ,
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<br />.11.11111....1111...................1111... .......11.......................................
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<br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION
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<br />. . r e\}(.\'-' ~
<br />~ ELECTRICAL :$ d j'-{ 00 ItfI;l9AM';;";;V1~ ~ PROGRESS ENERGY
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<br />D PLUMBING $ l_
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<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
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<br />D GAS D ROOFING 0 SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />
<br />...111......'...11,......11..11...11..'1'1111...'............11...11111.."...,.......................'.'1.........11......111.....11111111..'1111.
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<br />LOT #
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />D
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<br />W.R.E.C.
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<br />'35- pu':', +.
<br />
<br />S- &d .ADO
<br />per":, ~.
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<br />BUILDER I
<br />SIGNATURE
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<br />Address I
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<br />ELECTRICIAN~~ ~5i
<br />SIGNATURE . ~
<br />Address. q) c.... C-f-.. ~
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<br />COMPANY
<br />REGISTERED
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<br />YI N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />{4;..,rp:/1 ~!l"c8-l'~ M c-
<br />YI N FEE CURRENT I Y/N I
<br />License # I [5LI506/'3'??
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<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
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<br />I
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
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<br />License #
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<br />II , . . . r I IIIIIII I' IIIIIII1II , , I , IIII , III1IIIIIII , , , , , IIIIII , , II till' 111111111 , 11111 t III11III , 1111111 , II , II , III1III , I111IIIII1II11111 , I , , 1 , , , IIIII ,
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<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
<br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
<br />All commercial requirements must meet compliance.
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction. .
<br />I I I I ~ ~ ~ j . j j I j I j I ~ I . I I I I I . I I j 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 I I I I i I II I I I I i I I I I I I I 1.11 I I I I I Iii I I i I i I I I i I Iii
<br />Directions:
<br />Fill out application completely.
<br />Owner & Contractor sign back of application. notarized
<br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
<br />
<br />.. Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Driveways Fences (PloUSurvey/Footage)
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