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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t"'ernlll f\ppllLdllU11 <br />Building Department <br /> <br />Owner's Name <br /> <br /> <br />- <br />1...015 <br /> <br />q-~~ <br />S f/;t/ C E(Q. <br />& rf.. ':j t- <br /> <br /> <br />@ <br /> <br />Date Received <br /> <br />OWner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />6-04/ <br /> <br />, <br />Owner Phone Humber <br /> <br />Owner Phone Humber I <br /> <br />OWner Phone Number r <br /> <br />Fee Simple Titleholder Address <br /> <br />I 5CJL/1 <br />I <br /> <br />JOB ADDRESS <br /> <br />~. III Sf" <br /> <br />LOT# I <br /> <br />I <br />~ <br />D <br />D <br /> <br />PARCELID#L \\ - ~lp~d.\- OD'D.' -a-o/OO -ObCoO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />ADD/ALT 0 SIGN D MOVE 0 DEMOLISH <br />REPAIR <br />COMM 0 <br />FRAME 0 <br /> <br />OTHER I <br />STEEL ~ <br /> <br />SUBDIVISION <br /> <br />B <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I JZAt,.:.L b J e C'/f I? P<::} A. f <br /> <br />BUILDING SIZE I I?)( ~ I I SQFOOTAGEI ,j'7t6 I HEIGHT Iq ;;~~IJ/t'tlt I ,,-ft Si.tc;:. <br />1I11 I111111 I II , I . 1111 III . . 11111 111I . 111111111111111111 . 111111111111111111111111111111 ' ; 1111111111 ' 111111111 . 1111111111 ' I , I .. . I . . , ' 1111111111111 ' II <br />o BUILDING '1$ <br /> <br />o ELECTRICAL 1$ <br />o PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />o GAS 0 <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />OTHER I <br /> <br />C\CS'J.(o5 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ROOFING <br /> <br />AMP SERVICE 0 PROGRESS ENERGY 0 <br />~1J;6 ~~L- ?~ ip6'd,.. ~ uJ(~J.bu.c(~ <br />~.J.". f\i,.) ~~ -rrHJ I Y\ 6~ <br />v ~'iLATION OF MECHANICAL INSTALLAT . <br />jtfJf)rt....^J r'"'l- lrr74^- 209M" ~ \. <br />D V ~PECIAL TY 0 OTHER <br />I FLOOD ZONE AREA DYE <br /> <br />W.R.E.C, <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />I License # I I <br /> <br />1111I1111111111111111111111111111111111111111111I1111111111111111111111111111 i 1111111111111111111111111111111111111111111111111111 <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 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 />II.IIII!IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111111111111111111111111I1111111111111111I11111111111111111111111I1111111111111111 <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 />""7, <br />,,~~ <br /> <br />r/L~ <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />YIN <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SiGNATURE <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 />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />YIN <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 />