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<br />813-780-0020 <br /> <br /> <br />City ot Lepnyrnllls .....ernlll J-\ppllvdUUII <br />Building Department <br /> <br />Date Received <br /> <br />LOT # <br /> <br />I <br />I <br />! <br />I/qnol <br />I <br /> <br />Owner's Name <br /> <br />12'i:3A S+, <br /> <br />1 PARCELID#W" Z-C#- '2.1 -0010 - o"OO-dCfo <br />(OBTAINED FROM PROPERTY TAX NOTICE) ~ <br /> <br />r==I ADD/ALT D SIGN D MOVE D ~ <br />. D REPAIR <br /> <br />D COMM D <br /> <br />D FRAME D <br /> <br />DESCRIPTION OF WORK lJx rv\6 ~'.J,'otV of ~N-h't.€ Sf1LVCNtL. <br /> <br />BUILDING SIZE I I SQ FOOTAGE II nO I HEIGHT I <br />II II1I . I I . I III , I , . III , . III I , 1111 , II I .. I 1111 , " , , II , n I ., II I 1111111111111 , 111111 I II r II . 111111111111111 , 111111111 , I , II , I " r 111111 " n 111111111t 11111 <br /> <br />D BUILDING '1$ (0 J sc:x:>. :=1:.1 <br /> <br /> <br />D ELECTRICAL 1$ I <br /> <br /> <br />D PLUMBING 1$ I <br /> <br /> <br />D MECHANICAL 1$ I <br /> <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111111111111111.1111111111I11111I111111111111111111111111I111111I1111111111111111111111111111111111I111I111111111111 <br /> <br />COMPANY I C Vb <; s Co r-J<; Mv '- i,'o 't\J I <br />REGISTERED I Y I N I FEE CURRENT I Y I N I <br /> <br />LIcense # ~ (' (5bS- (f (., I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br /> <br />LIcense # I I <br /> <br />11111111111111111111111111I1111111111111111111I11111111111111111111111111I111I1111111111111111111111111111111111111111111111111111 <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 />All commercial requirements must meet compliance. <br />Attach (2) sets of Engineered Plans. <br />***~PROPERTY SURVEY required for all NEW construction. <br />11.1111'111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111I111111111111111111111111111111111111 <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 />Owner's Address <br /> <br />Fee Simple Titleholder Namel AJ III <br /> <br />Fee Simple Titleholder Address I flJ /11 <br /> <br />15Q'Z?? <br />I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />OTHER I <br />STEEL D <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />jJO fe~o / <br />L ,Jul-t1f etJ2f}f V <br />Ai () . ...tilt 'yt f1!" <br />W~ SI/ <br /> <br />Address <br /> <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <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 />PLUMBER <br />SIGNATURE <br /> <br />YI 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 />YI 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 />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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />