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<br />813-780-0020 <br /> <br />City ot Lepnyrmlls t"ernlll J-\fJfJlIl.idLlUII <br />Building Department <br /> <br />Date Received <br /> <br /> <br />yv( Il-L <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 ~1--=S t/ <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I c; I L..\1, O~~ ~ <br /> <br />I <br />~CZ <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />(9, LL . <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />~ /00 <br /> <br />Address <br /> <br />LIcense # <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 /> <br />License # <br /> <br />Address <br /> <br />t21~~l-\'~~At:.~tr 11 ,.JC <br /> <br /> <br />License # I <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI 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 />111111111111I11111111111I1111111111I1111111111111111111IIIIIIIIIIIIIIIIIIilllillllllllllllllllllllllllllllll1IIIIIIIilllllllUIIII <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 onsile, 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 onslle, 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 />111111111111111111111111111111111111111111111111111111111111 1 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />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 />