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<br />813-780-0020 <br /> <br />City ot Lepnyrmlls t'ernlll f\pplllidUUII <br />Building Department <br /> <br />Owner's Name : () ., en 2.0 <br />Owner'sAddress \7G,4 S Green Sk\p€- Dv <br /> <br />Fee Simple Titleholder Namel <br /> <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 />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />13 7lc 0 ( L I/!:J 13 eo. [),).e.- <br />IG~()d )-/6VJ UJVl I PARCELID#134-25-2)-OJ10- 00 ()(>('. --2510 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />D NEW CONSTR r=J ADD/All D SIGN D MOVE D DEMOLISH <br />[JZ] INSTALL D REPAIR <br />PROPOSED USE D SFR 0 COMM D OTHER Im6 bllQ.., <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I I <br /> <br />DESCRIPTION OF WORK I \fJ cb U>. h~ s.e. t. gf! :: <br /> <br />BUILDING SIZE I Z 7 f.-. (p 0 I SQ FOOTAGE 11[; 2 () I HEIGHT I I <br />II II 1111111 1111111 III I . II . III II . . I , III III , 11111111111111111 , 11111111111111111111111111 ; 1111111111 , II . 11111111111111111 . II . 1111111 . 1111111111111111 <br /> <br />LOT # <br /> <br />12- 5 L/ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />D BUILDING 1$10000 ,(j 0 I <br /> <br />, <br /> <br />D ELECTRICAL 1$/500,00 I <br /> <br />D PLUMBING 1$ 500" 0(;' I <br /> <br />D MECHANICAL 1$ /000 ,0 .. I <br /> <br />D GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO <br /> <br />1111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111 <br /> <br />BUILDER ~ COMPANY <br />SIGNATURE REGISTERED <br />Add.... Ii? LJ '. . . . . . L /) u""",.. I <br /> <br />~:-.:';:~~~N~~. ~::,: IJ{~;N FEE CURRENT Y/N I <br /> <br /> <br />Address ~ _ License # I I <br /> <br /> <br />:~::~E ~~, . . ;:'0= 1l3t~:fe;d","t,H~ Y/N I <br /> <br /> <br />Address License # I I <br /> <br /> <br />:,~~~~~~:L~~ ;:'o~= 11c-tN FEE CURRENT Y/N I <br /> <br /> <br />Address ~ License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE , REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address I I License # I I <br />111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111I111II11111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms . <br />Minimum ten (10) working days atter 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 atter submittal date, Required onsile, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans, <br />....PROPERTY SURVEY required for all NEW construction, <br />II,IIII!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />.u 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 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />. PROGRESS ENERGY <br /> <br />o <br /> <br />W,R,E,C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <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 />