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813-780-0020 City ot Lepnyrnllls t'ernlll J-\~fJlIl.idllUII Building Department Date Received Owner's Name ~~ -.S ~p, F;;G1fre Owner Phone Number Owner Phone Number I Owner Phone Number I Fee Simple Titleholder Address I 5,J- I ~ ADD/ALT D CJ REPAIR D COMM 0 OTHER C8J FRAME 0 STEEL D OTHER I 5 FJ~ ct/',~.o..\ Sw,(Jc.l'~ .~It'-<- ~';uer<G. /-/~;f/'~c:- I BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I TITII,III"II"""I","""1111)1""'IIIII"".I"'.'11111111111111111111111'111"11111'111111111.1111'11111111'111111111111"'11111.1111'11'11 ,-, BUILDING '1$ I L-J ~,CSO D ELECTRICAL 1$ --e:r I D PLUMBING 1$ I D MECHANICAL 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 11111111111111111111111111111111111111111111111111I11111I11111111111111I11111111111111111111111111111111111111111111111111111111II1111111111111111 I I I I I I I I I I License # I I 11111111111111111111111111111111111111111111111111111111I1I11111I1I1I1111 i III i 111I111111111111111111111111111111111111111111111111 Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms . Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Sanitary Facilities & 1 dumpster Attach (3) sets of Building Plans; (1) set of Energy Forms, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance, Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. 11.111111111111111111111111111111111111111111111111111111111I111111111111111111I1111111111111111111111111111111111I11111111111111111111111111111111 Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC JOB ADDRESS _~')so 7ti Zp LrY l,< 1)-; I PARCEL ID#I SUBDIVISION WORK PROPOSED E3 o D I Il~ 'MLN ~ PROPOSED USE TYPE OF CONSTRUCTION NEW CONSTR INSTALL SFR BLOCK DESCRIPTION OF WORK n 33~q^ LOT # (OBTAINED FROM PROPERTY TAX NOTICE) SIGN D MOVE D DEMOLISH AMP SERVICE VALUATION OF TOTAL CONSTRUCTION PROGRESS ENERGY D D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION ;Ve? 1\/ -e:. BUILDER SIGNATURE .~ Address ELECTRICIAN \" ~(\;U\C.lL SIGNATURE COMPANY ,. REGISTERED Address PLUMBER SIGNATURE COMPANY REGISTERED Address MECHANICAL SIGNATURE COMPANY REGISTERED Address OTHER SIGNATURE COMPANY REGISTERED Address 111111111111111 RESIDENTIAL COMMERCIAL SIGN PERMIT Ov"v ~/Z- I Y / N I . FEE CURRENT Y/N License # ~h6.... <2t~~ [Y/ N I FEE CURRENT I Y/N License # I Y/ N Y/N FEE CURRENT License # Y/ N Y/N FEE CURRENT License # Y/N Y/N FEE CURRENT Driveways-Not over Counter If on public roadways..needs ROW Fences (Plot/Survey/Footage)