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<br />813-789-0020 <br /> <br />City ot Lepnyrnllls t'ernllll-\\J\JlIljdllUII <br />Building Department <br /> <br /> <br />Date Received <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />13 rt,r'll l#JlYdJ:',LeJ U/)!.,i{ //;/~ <br /> <br />I sit tIt fI cJ Lt.!}' j,(J <br /> <br />B <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I s ~ !<...fi,i;';Y <br /> <br />BUILDING SIZE II i I 8 'X p, IS/II sa FOOTAGE I I HEIGHT I <br />1111111'11111111'111"."11111"1'11"111'11111111111''11111111111111111111111111111111111'111111'11""1'11111'111."1111"11"'1111111'111111111 <br />O BUILDING '1$ <br />360, OD <br /> <br />o ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />o MECHANICAL 1$ <br /> <br />o GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />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 />111111111111111111111111111111111I111111111111111111111IIIIIIIIIIIlllllllilllilllllllllllllllillllllllllllll1IIIIIIIilllllllllllll <br /> <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 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 onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />Ail commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />.'.~PROPERTY SURVEY required for all NEW construction. <br />111111111111111111111(1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />I <br />B <br />D <br />D <br />f<t?tll1 <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br />BLOCK <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />o/)~t4t51~ <br />I <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />License # <br /> <br />Address <br /> <br />LOT # <br /> <br />2.1 <br /> <br />PARCEL ID#I 0:2. <br /> <br />:J- & )..{ t'J;;" b C1 (;7 O()Of/ ();).. J P <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />ADDIALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />o <br /> <br />W.RE.C, <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br /> <br /> <br />11(~ <br /> <br />,~~ <br />I YIN <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />License # <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Driveways-Not over Counter If on public roadwaysooneeds ROW <br /> <br />Fences (PlotlSurvey/Footage) <br />