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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t"ernm f\\J\JII~allull <br />Building Department <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name E u ('\. \ <br />Owner's Address I ~~Y: \\ \ ~'tt.\ ~, 7.{fho l"~\\W <br /> <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />13~4-\ \ <br />I <br /> <br />D <br /> <br />Z4.~Is, FL ~~ I lOT' I <br /> <br />I PARCEL ID# I o a.- ().to"':l--\ - OO~- DDOlro- O~l 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />o NEW CONSTR cp ADD/ALT D SIGN D MOVE D <br />D INSTALL [}[] REPAIR <br /> <br />PROPOSED USE D SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I <br /> <br />DESCRIPTION OF WORK ~(,\\r- ~\~~~~1\Jl(:L.Jo ~\ ~(.l.\) 'OO~ ~l(~ ~dvd-ors <br /> <br />BUILDING SIZE I . I SQ FOOTAGE I I HEIGHT I I <br />IIIIII , I IIIII1 , I . 1111 , . II , I , , II P . II , 11111 , 11111111 , 1111 I 1111111111111111111111111111 r 111111 t 1111111111111 I II " I I II , I I , . 11111 , 11111111 " III1IIII . II <br /> <br />1$ I <br /> <br />Ii] ELECTRICAL 1$ Lfoc- I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111I1111111111111111111111111111111111111111111111111111I111111111111111111111111I11I11111111111111111111111111111111111111111I1II11111I1111111111 <br /> <br />:~~~~RE I ;:: I Y I N FEE CURR,NT Y I N I <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I <br />I <br /> <br />I License # I I <br /> <br />1111111111111111111111111111111111111111111111111111111111I1111111I111111 i 111I111I11111111111 i 1111I11111I11111111I11 j 1111111111111 <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 />11111111111111111111I1111111111111111111111111111111111I11111111111 II 111I1111111111111111111111111111111111111111111111111111111111111111111111111 <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 AlC <br /> <br />l <g-\b ~t- <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE loo <br /> <br />~ <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />ELECTRICIAN t <br />SIGNATURE <br /> <br />License # <br /> <br />{~~ ~'-R-~ I <br /> <br />'r.O. B\:))t ~~d... ~nq(~;(l~. R- o~~'t-Q~ <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />fK~ t;le.vhiLc.J <br />I Y I N I FEE CURRENT <br /> <br />License # I' #~ <br /> <br />~Y/N <br /> <br />Address <br /> <br />PLUMBER <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 />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 />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Pial/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />