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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t"errrlll J-\lJlJlIljdllUII <br />Building Department <br /> <br />Date Received <br /> <br /> <br />fAl tJ ~~ s.. <br />15J 00 <br /> <br />L,€- ~ (;)} I t"J1-W\ s <br />J7~ St-~+ <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Humber I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />151D~ <br />I <br /> <br />WORK PROPOSED <br /> <br />/ 7~ ~f- <br /> <br />I <br /> <br />D NEW CONSTR c=J <br />D INSTALL . CI <br />PROPOSED USE 0 SFR D <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK 1fV\~ -,1I1L~&f~ <br /> <br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I <br />Illflll"IIIIII111'111111111111,111111111111111111111''1IITIII'IIIIIIIIIJIIIIIII,tllrlllll'1111111111111111111'111'111111'111111111111111111111111 <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCELlD#1 <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />ADDIAL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />D <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />D <br /> <br />1$ I <br />1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111111111111111.1111111111I11111111111111111111111111111111111111111111111111111111111111111111111I11I11111111111111 <br /> <br />:::!~~~RE I ::.~:= I Y / N FEE ClJR_ Y / N I <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 />111111111I11111 111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111 <br /> <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 onsite, 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 />....PROPERTY SURVEY required for all NEW construction. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />BUILDING <br /> <br />VALUATION OF TOTAL CO~S70N <br />AMP SERVICE .. PROGRESS ENERGY <br /> <br />o <br /> <br />W.RE.C, <br /> <br />~ ELECTRICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />ELECTRICIAN ~ ., j <br />SIGNATURE ~ <br />- <br /> <br />License # <br /> <br />'" <br /> <br />lAJ~~ <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 />PLUMBER <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 />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />YIN <br /> <br />MECHANICAL <br />SIGNATURE <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 />Address <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 />