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<br />Date Received <br /> <br /> <br />City ot Lepnyrmlls ~ernlll t\jJjJlllidLlUII <br />BUilding Department <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />N//A. <br /> <br />Fee Simple Titleholder Address I AI..#} <br />, <br /><.0 D " <br /> <br />JOB ADDRESS <br /> <br />AtO'--ll 'B\v4. <br />I <br /> <br /> <br />D NEW CONSTR r==l <br />D INSTALL . D <br /> <br />PROPOSED USE D SFR 0 <br /> <br />TYPE OF CONSTRUCTION D BLOCK 0 <br /> <br />DESCRIPTION OF WORK Il:>eml) t.h. ON of f\t.. e -W ~ It I I d. f ~ <br /> <br />BUILDING SIZE I I SQ FOOTAGE I 2250 nJ HEIGH.;-j <br />I111III , I II , III 111111 " I I , , lilt r I III , I1I1 , I " 1111111 t I I , 1111111111111 " 11111111111 fit " III , 1111 It 1111111111 " 11I1I111 ., III 111111 111111 , 11111111111 <br /> <br />I <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCEL ID#I <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) ~ <br />SIGN D MOVE D ~EMO~ISIiJ <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />1$ 2 3 9~ fl.S1 I <br /> <br />D. ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11II1I1111I1I1111111 <br /> <br />BUILDER i5.C v COMPANY I CV"'OSS Co""s'ivu<:..f-iotV I <br />SIGNATURE REGISTERED I (!] N I . FEE CURRENT I Y I N <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />I License # I I <br />11111111111I1111111111111111111111111111111111111111111111111111111111111 i III i 111I1111111111111111111111111111111111I111I111111111 <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 />*mpROPERTY SURVEY required for all NEW construction. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />D <br /> <br />BUILDING <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 /> <br /> <br />K 3~~ <br /> <br />I <br /> <br />License # <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <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 />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 />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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />