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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls ~ernlll f'\jJjJllvi:lUUII <br />BUilding Department <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 Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />s+-- <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />~ Ct-"l.ll <br /> <br />LOT # <br /> <br />SUBDIVISION I PARCEL ID#I I /~ ZG-2/ . -GO /0-- J/400.....0IbO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> B NEW CONSTR B ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH <br />WORK PROPOSED <br /> INSTALL REPAIR <br />PROPOSED USE D SFR 0 COMM 0 OTHER I <br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL 0 OTHER I <br />DESCRIPTION OF WORK I Lf( c ~ Cit i/'l [Ill f <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />c=J GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />c=J <br /> <br />c=J <br />c=J <br />c=J <br /> <br />BUILDING SIZE I I L~;:;"'AGE I IS'S I I HEIGHT I 4 <br />11I1 1111111 1 II , 1111111111 , I 11111111 , 1111111111111111111111111111111111111111111111111111111111111111 P111111111111111111111111111111111111111111111 <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />BUILDING <br /> <br />II fo2-. O() <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY 0 <br /> <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />II- <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />, t1 I1JI/VIIt /;4f' <br />FEE CURRENT <br /> <br /> <br />Address <br /> <br />$10 <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 />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 />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />