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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t""ernlll J-\jJjJlllidllUII <br />Building Department <br /> <br />Owner's Address <br /> <br /> <br />1d/l1 0,vN.../A <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Fee Simple Titleholder Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address <br />I D5"tf &7*,,1/ t8/vO <br />I <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCEL ID#I <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />I <br /> <br /> <br />D NEW CONSTR C:=J <br />D INSTALL CJ <br /> <br />PROPOSED USE D SFR 0 <br /> <br />TYPE OF CONSTRUCTION D BLOCK 0 <br /> <br />DESCRIPTION OF WORK I /J? E/i::/Z. ch '7 N9 c 0- (.I--f <br /> <br /> <br />BUILDING SIZE I I SQ FO~TAGE I HEIGHT I <br />TIT.. , I I , , 1II1II1III1 , . 111 , , , In. II , I 1111 " , 11111111111 , I , 111111111111111111111 n III 111111 ,. 11111111 fit ~ 1111111111 , I II , 111111111111111111111 ., III1 <br /> <br />WORK PROPOSED <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />D <br />D <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />License # I I <br />1111111111111111111111111111111111111111111111111111111111111111111111111 i 111111111111111111111111111I11111111111111111111111111II <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 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.'11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC <br /> <br />1$ <br /> <br />cgl ELECTRICAL 1$ B DO' .,." <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br />111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1I1I11111111111111 <br /> <br />BUILDER I COMPANY I I <br />SIGNATURE , REGISTERED Y I N FEE CURRENT Y IN <br />Address I License # I <br />ELECTRICIAN 1_(')17/ /J tZ :I COMPANY +>C . <br />SIGNATURE_~ REGISTERED N <br />Address I License # I F /Z () CJ 1:::-1 9 '7 <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br />200 <br /> <br />ro <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R,E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <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 IN <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 />