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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t"ernlll J-\I-'I-'IILdllUII <br />Building Department <br /> <br />Date Received <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />OWner Phone Number I <br /> <br />,/ Owner's Name <br /> <br />/ OWner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />/ JOB ADDRESS <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I <br /> <br />I <br />,%3 5' 23~ <br /> <br />sr <br /> <br />~-PHYI< l-I-iuJ FL- <br />PARCEL ID#I <br /> <br />:?q!J-V~ <br /> <br />LOT # <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />o <br />o <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />o <br />o <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 DEMOLISH <br /> <br />OTHER I <br />STEEL 0 <br /> <br />SUBDIVISION <br /> <br />/' DESCRIPTION OF WORK I Dl:.L-1 v'e-.e-Lf s:' ;X,-tjJ ot fufA-.b ~>f~ ~t.DJNGt <br /> <br />./ BUILDING SIZE I 1,3.. I )( 31-' I /SQ FOOTAGE I 3ifL1 I HEIGHT I I <br />111'11'11'111111111111'11'11111"111'111'1111111111111111111111.11.111111;111111111111;1111'11111111111111"1111111111'11111111"11111111111111'11 <br /> <br />'1$ 5'loOD. C50 I <br /> <br />o ELECTRICAL 1$ f\LJYUL- I <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 />1111111111111111111111111111111111111111111111,1111111111111111111111111I111111111111111I11111111111111111111IIIIIIIIIIIIIIIIIIIIllllllllilllllllll <br /> <br />/:::::f,.~~RE ~.~ qf),"C I ~~~:::I ~YW:~RRENr VI" I <br /> <br /> <br />I License # I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />OTHER I <br /> <br />WORK PROPOSED <br /> <br />/0 <br /> <br />BUILDING <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 />~oC- _ <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />ELECTRICIAN I <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 />License # <br /> <br />1111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllllllllllll1IIIIIIIilllllllllllll <br /> <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 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 onsile, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance, <br />Attach (2) sets of Engineered Plans. <br />*mpROPERTY SURVEY required for all NEW construction, <br />IIIIII!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111I1111111111111111111111111111111111111111111111II111111111111111111111111111111111 <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 <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 />