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813-780-0020 City ot Lepnyrnllls t'ermll J-\JJfJlIl,;C1l1UII Building Department Date Received It~S Owner Phone Number Owner Phone Number I Owner Phone Number I Owner's Name Owner's Address Fee Simple Titleholder Namel JOB ADDRESS Fee Simple Titleholder Address I I .S"A Lflj I ,~-r.E- .51 lOT # DESCRIPTION OF WORK I PARCELlD#I, \ -.;;2.~-2-t - 00\0 -130100 ~ O\~ (OBTAINED FROM PROPERTY TAX NOTICE) D ADD/ALl D SIGN D MOVE D DEMOLISH [J;]- REPAIR c==J COMM D OTHER I c==J FRAME D STEEL D '- R- E:--/2o () )C tJ t/ G /L G 1- ;.r 1/ ~ P s-IJ) )1/ ? t..-&--5 BUILDING SIZE I ISQ FOOTAGE I I HEIGHT I ,1.......1111111111111111...1.,...1,'.....111.1111111111'1111....111.............111.......1111....1111.......'1111.111.....1111......'.....11.... SUBDIVISION PROPOSED USE TYPE OF CONSTRUCTION ~ D D I NEW CONSTR INSTALL SFR BLOCK WORK PROPOSED OTHER I I I I I D GAS CQ---ROOFING c==J SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO ,"11"11111""""11""""""""""""1""'""'11"""""""""""11,,,,1""""""""1111ii,',IIII",II",.,.,'I"I"",II"", D BUILDING 1$ ~ <-j()() 1 ~rp 0 ELECTRICAL 1$ D PLUMBING 1$ 0 MECHANICAL 1$ VALUATION OF TOTAL CONSTRUCTION AMP SERVICE c==J PROGRESS ENERGY D W.R.E.C, VALUATION OF MECHANICAL INSTALLATION Y/N FEE CURRENT License # Y/N FEE CURRENT License # YI N FEE CURRENT License # Y/N FEE CURRENT Y/N I I I I I I I I I I BUILDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN SIGNATURE COMPANY REGISTERED Y/N Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N Address MECHANICAL SIGNATURE COMPANY REGISTERED Y/N License # I IU"~:V~ FEE CURRENT I Y I N I -:?:J S-~ License # I eC (90" b 2--'"/ J 111I111111111111111111111111111111111111111111111111111111' 1111111111111111111111111111111111111111111111111111111" 111111111111111111111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Stormwater Plans wi Silt Fence Installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wi Slit Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 i 111111111111111111111111111 i 11II111111 i 11II1I i 11111111 Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same Address OTHER SIGNATURE I cff I' .~ I Po jJ 4)'-/- I 'J t.:J COMPANY REGISTERED {;-Ih,l; ~ I YI N I Address ~.[. ~v COMMERCIAL SIGN PERMIT OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (PloVSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW