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813-780-0020 City ot Lepnyrnllts t"ermll J-\fJfJlILdllUII Building Department Owner Phone Number OWner Phone Number I Owner Phone Number I Date Recelvea Owner's Name Owner's Address I C ~ L{'i Fee Simple Titleholder Namel 8;r mf^) l..t.-. Fee Simple Titleholder Address I ),Jo ~d n\~. ?-cfJ...'jr/..I'J/~ " ~L. 33>'1" lOT # JOB ADDRESS . \ SUBDIVISION I I PARCEL 10#1 /1-2 (p - Z!-6010 -05700 -02- (OBTAINED FROM PROPERTY TAX NOTICE) NEW CONSTR B ADD/ALT 0 SIGN D MOVE D DEMOLISH WORK PROPOSED INSTALL REPAIR PROPOSED USE SFR 0 COMM D OTHER I TYPE OF CONSTRUCTION BLOCK 0 FRAME D STEEL D OTHER I BUILDING SIZE HEIGHT I . . I . . . I . I ~ . . I I . I . . I . I I . . . . I . . . . I I I . . . I . I I I I . . I . I . I I . . I . . . I I I I I . . I I I I I I I I . . . . . . . . I . I . . . . I I . , I . . . I . . . , I . . I I I I I I I I I . I . . I I . . i I . . I . . I I . . . I I . I I . I I . . I I . I D BUILDING 1$ I D ELECTRICAL 1$ I D PLUMBING 1$ I D MECHANICAL 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO 111"ltll""",'IIIIII",,,,"IIIII"'."'."""""""",.."",","1......'11,,"11"""""'11"""1'"'111i,II"II,.III"".'II"'I"."II",,111 VALUATION OF TOTAL CONSTRUCTION AMP SERVICE o PROGRESS ENERGY D W,R.E.C, VALUATION OF MECHANICAL INSTALLATION Y/N FEE CURRENT License # Y/ N FEE CURRENT License # Y/N FEE CURRENT License # Y/ N FEE CURRENT License # Y/ N FEE CURRENT License # Y/N I I I I I I I I I I BUILDER SIGNATURE COMPANY REGISTERED Address ELECTRICIAN I SIG~ATURE Address I PLUMBER I SIGNATURE Address I MECHANICAL I SIGNATURE ~I~HN~~:~ I ~ Address I COMPANY REGISTERED Y/N COMPANY REGISTERED Y/N COMPANY REGISTERED Y/N - I 152. Y> COMPANY REGISTERED I ~ Y/N 11111111111111' 1111111111111111111111111111111111111111111" 111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans w/ Slit Fence installed, Sanitary Facilities & 1 dumpster; Site Work Pennit for subdivisions/large projects COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Fonns. R-O-W Pennit for new construction. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. 1111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111 i 111111111111111111111111111 i 11111111111111111111111111 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 OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage) Driveways-Not over Counter If on public roadways..needs ROW