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<br />813-780-0020 <br /> <br />City ot Lepnyrmlls t"ernllll-\ppll\JdUUII <br />Building Department <br /> <br />Date Received <br /> <br /> <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 />Fee Simple Titleholder Address <br /> <br /> <br />PARCEL 10# <br /> <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />( <br />SIGN <br /> <br />o <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />o <br />o <br />o <br /> <br />OTHER IV\I\c..bl\.L- Y'\c..\'U1 <br />STEEL 0 OTHER I <br /> <br />o NEW CONSTR r=:J ADD/AL T <br />ffi- INSTALL D REPAIR <br />PROPOSED USE 0 SFR 0 COMM <br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME <br /> <br />DESCRlPTlDN DF WORK ~1 \R ~~0 Jl-+ -LZ P <br /> <br />BUILDING SIZE 1 /{i X '1.2 I SQ FOOTAGE 2-1 /J I HEIGHT I I <br />1111111'111111"11111 'I~III'II'I;III'IIII'I'II'IIIII'I'II'IIIIIIIIIIII~IIII111111111'111111111111'11'1111111111111111'1111111111'"'1111111111'1'1 <br />o BUILDING '1$ 35,6 D () 0 c> I <br /> <br />, <br /> <br />o ELECTRICAL I$!" ODO. (o~' I <br /> <br />o PLUMBING 1$ 660. CO\) I <br /> <br />o MECHANICAL 1$ /500 00 I <br /> <br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />I11111111111111111111111111111111111111111111111111I1111111111111111111I11111111111I111111111111111111111111111I1 11111 11111 11111 111I1 III ill 11111 II <br /> <br />BUILDER I' - · ~~ A ~ _' A COMPANY 18f111l ,~h dri 1"1 H s I <br />SIGNATURE . ~ ~~ _ _ ~ _ __ Of 1f;i;T REGISTERED. Y I N I FEE CURRENT Y / N <br /> <br />Address License # I I <br /> <br />~::~;~~~:N I. Lv "^r ~ .JJ ;:': 1Ar ~ I N FE' CUM'NT Y I N I <br /> <br /> <br />Address . License # I I <br /> <br />PLUMBER I' - · rI. ~ · A CD"PANY rP:; HwheJd 1~1J 4 : <br />SIGNATURE. ~ ~ u....~ REGISTERED w..::::::, Y / N I FEE CURRENT Y IN <br /> <br />Address License # I <br /> <br />~~~~~~I~:L ! Lv ~r 1J..nEt l.I ;.~:~:~ IA;c y~ N FE' CURRENT Y I N I <br /> <br /> <br />Address License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE REGISTERED Y I N FEE CURRENT Y I N <br /> <br />Address I I License # I I <br />1111111I1111111111111111111111111111111111111111111111I11111I111111111111111111111II11111I1111111I1111111111111111111111111111111I1111111111111111 <br />RESIDENTIAL 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 />**uPROPERTY SURVEY required for all NEW construction. <br />11.1111'1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 Attomey (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 />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 />l-JtL.J <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />