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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t'ernlll1-\IJIJ"LdllUII <br />Building Department <br /> <br />Owner's Name <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />1 lez. {rfl c( (2 . <br /><7;+, ~Pt'l~'l.dl"(:.L I <br />I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />1(.oDIOI2~6-L <br />I <br /> <br />LOT # <br /> <br />I <br /> <br />B <br /> <br />D <br />D <br /> <br />DESCRIPTION OF WORK I <De.mo I ; -it. b rJ 0.(' (' D/0 tip MrJf1 J blo L k h () v'f <br /> <br />BUILDING SIZE I I SQ FOOTAGE I .5'70 I HEIGHT I /2'- <br />1I1111111 11111111111111 , I ' III III 1111111111111111111111111111111111111111111111111111 1111111111111 . 111111111111111111111 , ' 1111111111111111111111111 <br />D BUILDING '1$ 2 ~ SD ,~() I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATiONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111111I11I11111I11111111I1111111111111111111111111111111I1111111I11111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIlllilllllllll <br /> <br />:~~~~~RE ~ ;~:~~~~ 1~~(~f~~E~--k~~~'~J I <br /> <br /> <br />License # I I <br /> <br />I <br />I <br />I <br /> <br /> <br />Address License # I <br /> <br />MECHANICAL I COMPANY I <br />SIGNATURE , REGISTERED Y I N FEE CURRENT Y IN <br /> <br />Address I License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE , REGISTERED Y I N FEE CURRENT Y IN <br /> <br />Address I I License # I I <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 i 1111111111111111111111' 1111111111111II1111 j III1II1111111 <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 />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 />Attach (2) sets of Engineered Plans, <br />**uPROPERTY SURVEY required for all NEW construction, <br />I1I11I111111111 I I I I11111111I1I1111 I III I II I I III I II I I 11I1 I 11111 I 11111 II I11I11111 I 1111I11 I I11111 I 1I111111II111 I 1II11 I 11111I11111111111111111111111111 <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 />It. Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authOrizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />WORK PROPOSED <br /> <br />E3 <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PARCEL 10# I tfL - 2({; - Z 1- ()()5b ' OOOD {) - DO I b <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />ADD/ALT D SIGN D MOVE ~ DEMOLISH <br />REPAIR . <br />COMM D OTHER I <br />FRAME D STEEL D <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W,R.E,C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />