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813-780-0020 City ot Lepnyrnllls t"ernlll /"\fJfJlIlJdUUII Building Department Date Received Owner Phone Number Owner Phone Number I OWner Phone Number I I I 1~7() : Owner's Name Owner's Address Fee Simple Titleholder Namel JOB ADDRESS Fee Simple Titleholder Address I I '37 (P() It (;, II A ve_ lCrOi'lL) J-}oviZOh LOT # I PARCEL 10#1 3'-/' 2s - 2) , 0 II () -00000 - 2- 7 CJ 61 (OBTAINED FROM PROPERTY TAX NOTICE) D NEW CONSTR E3 AD DIAL T D SIGN D MOVE D DEMOLISH ~ INSTALL REPAIR PROPOSED USE D SFR 0 COMM 0 OTHER I t'YI6bll~ M lV] 0 J TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL D OTHER I DESCRIPTION Of WORK lrn12h U()ir\P , 2e,~ / BUILDING SIZE 121'1.52 I SQ FOOTAGE 1 . 'Z '-I 8 I HEIGHT I . I II II I I I I I I I I I I II , . I I I I , I I I I ~ I I I ;';,". I I I I I I t I I II I I II I II I I I I I II II I I I ; I II I I I II I ill I II I I I II II I I I , I I II I I II I I I II I I I , I I I I I I II I I I I I I II II I I I I II III III I II I ' I I D BUILDING .I$-p~ ('\C) I D ELECTRICAL 1$ . /" 6 () I J J 00. D PLUMBING 1$ 500. c c) I D MECHANICAL 1$ /000. 00 1 D GAS D ROOFING 0 SPECIALTY 0 OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 11111111111111111111111111111111111111111I11111111111I11111111I1111111I1111111111111111111111I1111111111111111111111111111111111111I1I111111111111 COMPANY I J7~ ;.-f-+viJeJ (1 1\1 t-f \ I REGISTERED 'f Y I N I FEE CURRENT 'I ~, N License # I I I I I I :,~~~l;:{~ eo.,-,nJ1d:.JJ ~~:~-:~ Gt~1 ~I FEE CURRENT Y I N I Address I License # I OTHER I COMPANY I SIGNATURE . REGISTERED Y / N FEE CURRENT Y I N Address I I License # I I 1111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111 i III i 1111111111111I1 i 11111111111111111111111111I111111111 RESIDENTIAL Attach (2) Plot Plans; (2) 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 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. 11.111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 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 SUBDIVISION WORK PROPOSED VALUATION OF TOTAL CONSTRUCTION AMP SERVICE o PROGRESS ENERGY ,.JDLJ D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION BUILDER SIGNATURE Address ELECTRICIAN [. ' _ . '".::' SIGNATURE : ~ ~ Address PLUMBER r-- SIGNATURE L..W~- Address I ~JJ COMPANY REGISTERED l~r(1 c Y / N FEE CURRENT Y/N ItJ1i::/ 1J COMPANY REGISTERED License # I 11f2]J.H<:/lieJi'J! /tAl-I, , 1 Y / N I FEE CURRENT K / N License # I COMMERCIAL SIGN PERMIT Fences (PloUSurvey/Footage) Driveways-Not over Counter If on public roadways..needs ROW