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<br />813-780-0020 <br /> <br />City ot Lepnyrnllls ~ernlll f\1-'1-'"LdLlUII <br />Building Department <br /> <br />tl61Cf4 <br /> <br />Date Received <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Sa 1/ <br /> <br />WORK PROPOSED <br /> <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br /> <br />{51 vel <br /> <br />PARCEL 10# I () 2. - ZIo- 2/-Cb(O - 02'1 ()() -D 0/ () <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />ADD/ALT D SIGN D MOVE D cEEMOLlSH') <br />REPAIR <br />COMM D <br />FRAME D <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE I I SQ FOOTAGE <br />III , 1111111111 I II 1 1 111111 1111111 1111111 111111111111111111111111111111111111111111111111111111111111111111111 ' , II ' 111111111111111111111111111111111 <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo <br /> <br />/111111111111111111111111111111111111111111111.111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111 <br /> <br />BUILDER I ~~DSS. CtW</v-vc'f, 'c,v S~rLi(d I <br />SIGNATURE _ Y I N I FEE CURRENT I Y I N I <br /> <br />Address Z C LIcense # I c. G,c., t;;lfC:;T7ltJ I <br /> <br />ELECTRICIAN I COMPANY I <br />SIGNATURE . REGISTERED Y I N FEE CURRENT Y I N <br /> <br />Address I License # I <br /> <br />PLUMBER I COMPANY I <br />SIGNATURE . REGISTERED Y I N FEE CURRENT Y IN <br /> <br />Address I License # I <br /> <br />MECHANICAL I COMPANY I <br />SIGNATURE . REGISTERED Y I N FEE CURRENT Y IN <br /> <br />Address I License # I <br /> <br />OTHER I COMPANY I <br />SIGNATURE . REGISTERED Y I N FEE CURRENT Y IN <br /> <br />Address I I License # I I <br />1111111111111111111111111111111111111111111111111111I11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllllllllllllllll/1111111111111111111111111111111111111 <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 onslte, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meet compliance. <br />AUach (2) sets of Engineered Plans. <br />*mpROPERTY SURVEY required for all NEW construction. <br />11.11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I <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 />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authOrizing same <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC <br /> <br />0 BUILDING <br />0 ELECTRICAL <br />0 PLUMBING <br />0 MECHANICAL <br /> <br />I to <br />2 L OD. - <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 />q13~ <br /> <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadwaysooneeds ROW <br />