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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t"ernlll J-\..,..,lIlJdllUII <br />Building Department <br /> <br />Owner Phone Number <br /> <br />~ ,Yh Vis Owne' phone Numb" I <br /> <br />Owner Phone Number I <br /> <br />~ <br />CY~ <br />\,){" .; {f' <br />)P <br />-'Jr;}.o <br /> <br />Date Received <br /> <br /> <br />SUBDIVISION <br /> <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />; Is <br /> <br />PARCEL 10# I'd ~ dW - d \ -. C:;1:)d.O... (jOdQ:)- O%-B{) <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />LOT # <br /> <br />/ JOB ADDRESS <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />o <br />o , <br />Ii a--fa / <br /> <br /> <br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I <br />1I1I11I . III I11I1 . . IIII 1 II 1 I1I1 I II11I II 1 1111 I 1111111 I III I III ,. 111111111111111111 I .. . 1111111 ., 1111111111111 . 111111111111111111111 . 111111111111111111 <br /> <br />B <br />o <br />o BLOCK <br /> <br />1/1e- Roo.(Z- <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />/ DESCRIPTION OF WORK <br /> <br />/' 00 BUILDING / :: I, 700' (/ tJ: <br /> <br />ELECTRICAL , <br /> <br />o PLUMBING 1$ I <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIlllllllilllllllll <br /> <br />COMPANY LJ.t D M e. 0 ()J )J e V I <br />REGISTERED I Y / N I FEE CURRENT Y / N <br /> <br />License # I I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />I License # I I <br /> <br />1I1111111111111111111I11II11111111111111111111I11111111IIIIIIIIIIIIIIIIIIilllllllllllllllllllillllllllllllll1IIIIIIIilllllllllllll <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms , <br />Minimum ten (10) working days after submittal date, Required onslte, 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 onslte, 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 />11.l111!1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 AlC <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W,R.E,C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />/ SIGNATURE <br /> <br /> <br />(cJ) , ~ '-' <br /> <br />Address <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 />PLUMBER <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 />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 # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />, FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <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 />