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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t"ernlll1-\tJtJlI\,;dUUII <br />Building Department <br /> <br />Fee Simple Titleholder Name <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I <br /> <br />LOT # <br /> <br />PARCEL ID#I <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br />BLOCK <br /> <br />I <br />B <br />o <br />o <br /> <br />ADD/All D <br />REPAIR <br />COMM D <br />FRAME D <br /> <br />OTHER I <br />STEEL D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br /> <br />SQ FOOTAGE I <br /> <br />HEIGHT I <br /> <br />D <br /> <br />D <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ I VALUATION ,Q.EMECHANICAL INSTALLATION <br /> <br />D GAS D ROOFING ~LTY D OTHER ' <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111I1I111111111111I1111I1111111111111111 <br /> <br />:~~~~~RE I ~~~';.'":,~ I Y I N FEE CURRENT Y I N I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E,C, <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <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 # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />License # <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <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 onslle, 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 />I1111I1111111111111 J 1111111111I111111111111111111111111111111111111 J 1111111111111111111111111 J II J 1111111111 J 1111111111 J 111111111111111111111111111 <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 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 NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />