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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls t"ernlll J-\jJjJlI\,idllUII <br />Building Department <br /> <br /> <br />Date Received <br /> <br /> <br />€ <br /> <br />8' 3 tJ4 5-/-. Ap+ <br /> <br />ID <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />OWner Phone Number I <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />15335 <br />I <br /> <br />I'i?~ <br /> <br />LOT # <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br />BLOCK <br /> <br />PARCELID#W -2 ~ - 21-0010 - [,300 -D"o <br />(OBTAINED FROM PROPERTY TAX NOTICE) ~ <br />ADD/ALT D SIGN D MOVE 0 ~ <br />REPAIR . <br />COMM c=J OTHER <br />FRAME ~ STEEL <br /> <br />o r:- S l' I\J <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br />OTHER I <br /> <br />BUILDING SIZE I I~ ~ I SQ FOOTAGE (3 52-- HEIGHT ~ <br />II J 11111111111 J I" J 111'11:' ;;'1";": I J, 11111111 J J 11111111'11111111111111 J 111111111111111111111'1111'111 P II J II' I111111 J '111'11 till' 'I J 111111' 1I1111111 <br /> <br />D BUILDING 1$ ~fJ7) I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS c=J ROOFING D SPECIALTY c=J OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br />1111111111111111111111111111I11111111I11111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllI1111 11111 11111 11111 11111 III ill 11111 II <br /> <br />:~~~~~RE I :;.~~'::.~ I Y I N FEE CURREN' Y I N I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />S~-J <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />License # <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 />PLUMBER <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 />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />License # I <br /> <br />OTHER I7"~D~.c; CQIC/<;+.-.r~-h'o~ <br />SIGNATURE L-) . Y / N . FEE CURRENT I Y / N I <br /> <br />Address '2 ~-z,. ( S Q. -;- W. License # I <br />1111111111111111111111111I111I1111111111111111111111111111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIillll111UIIII <br />RESIDENTIAL 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 on site, 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 />1111111111111111111111111111111111111111111111111111111111111111111" 111111" 11111111111111111111111111111111111111I111111111111111111111111111111 <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 />Address <br /> <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 />