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<br />813-780-0020 <br /> <br />City of Lepnyrnllls t'ernlll J-\\-l\-lIlLdllUII <br />Building Department <br /> <br />Owner's Name e ~ iJ1t <br /> <br />Owner's Address 1563;- <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />1_)Cv 3 5 <br /> <br /> <br />o <br />II ;;:;/ <br />9 ' <br />J3 ref :5-1 <br /> <br /> <br />ownerPho~er <br /> <br />Owner Phone Number <br /> <br />OWner Phone Number I <br /> <br />Date Received <br /> <br />) ~ '10/" <br /> <br />5'f <br /> <br /> <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />o <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />t:'r <br /> <br />- d& -.}/ - Do '-0 -00 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 DEMOLISH <br /> <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />~ <br />D <br />D <br /> <br />'l <br />e j \.., leV! <br /> <br />saFOOTAGEI~ <br /> <br />o <br />D <br />o <br /> <br />DESCRIPTION OF WORK <br /> <br />Ie TVlO ../0:::,... <br /> <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />I <br /> <br /> <br />1$ <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br />1111111111111111111I111111111I11111I11111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111I1I1I11111111111I <br /> <br />:~~~~RE r~~ ~- I ~~= II~o;;~ f~~'- Y/N I <br /> <br /> <br />Address L License # I <br /> <br />ELECTRICIAN I COMPANY I <br />SIGNATURE . REGISTERED Y I N FEE CURRENT Y IN <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />I License # I I <br /> <br />1111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIilllillllllllllllllllllllllllllllll11111I11111111I1111111 <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 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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111 <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 A1C <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.RE.C, <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I 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 />YIN <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 />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PlotlSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />