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<br />813-780-0020
<br />
<br />City ot Lepnyrmlls ~ermllI-\JJJJIIL;i::lLlUII
<br />Building Department
<br />
<br />.
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Name
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address
<br />: 35\'6'
<br />
<br />P1a.AV1 \ L- ~
<br />,
<br />
<br />LOT# 179
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCEL 10#1 6).'-\' -~ -do \ ~ cOda. CIX:;OO - 6790
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />ADD/All 0 SIGN D MOVE 0 DEMOLISH
<br />REPAIR
<br />COMM 0
<br />FRAME
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />OTHER
<br />STEEL
<br />
<br />BUILDING SIZE
<br />
<br />HEIGHT I
<br />
<br />D BUILDING 1$ ~ r 0 I
<br />
<br />c==J 1$ I
<br />
<br />c==J 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 />
<br />I I I , I I , II . , I I , I , I , , , . . It' I , , . I I I , W , , I I . I . . I I I I I , I , I , I . t . 1 , I . , , , . . . II , , , , , I I . I , I , . . . I , , , . I I P . , , I , I , I I I III , I , I ~ I I I , I I I , , , . I . , I , I I III , I , I . 11111 . , , I II
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br /> FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />
<br />Address
<br />
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Slit Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />""PROPERTY SURVEY required for all NEW construction.
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 i 111111111111111 11111111111111111111 i 11111I11I i 11111111
<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 Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public.roadways..needs ROW
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