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813-780-0020 City ot Lepnyrnllls I-'ermlt AppllCanOn Building Department rCl^-U I~-' uv-vv, I Date Received Owner Phone Number Owner Phone Number I Owner Phone Number I Owner'sName OUr ~V'lor Lu~he('", Owner's Address I 5'-)(" J.6tiJ S.h-ee.t- Fee Simple Titleholder Namel Fee Simple Titleholder Address JOB ADDRESS LOT # WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK I j) -J(,-)} - O() 0- 00'10 - 01 (OBTAINED FROM PROPERTV TAX NOTICE) B ADD/ALT D SIGN 0 MOVE D DEMOLISH REPAIR D COMM D OTHER I D FRAME D STEEL 0 OTHER I SUBDIVISION B PROPOSED USE D TYPE OF CONSTRUCTION D DESCRIPTION OF WORK IXNSkl1 ;)5' 'St-~ BUILDING SIZE I SQ FOOTAGE r- HEIGHT I "I I , I'll , " , " III t. II " 'II I . , , 'I I 11'11111 , I " 1"1111' " 'II " 'I' " '11'1111 , II , 111'11'1 lIP '111111 . , " " II . "'111111111111111 ; , , '11'11 , , . '1111111"1' 1$ SJ" 75: QfL I , 1$ I 1$ I 1$ I D GAS D ROOFING D SPECIALTY D OTHER FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII111111111111111111111111111111I1111111111111111111111111111I11111111I111111111I1111111111111 0 BUILDING D ELECTRICAL D PLUMBING D MECHANICAL VALUATION OF TOTAL CONSTRUCTION AMP SERVICE D PROGRESS ENERGY D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION BUILDER SIGNATURE Address License # Ie GC I ), 't Jb~ COMPANY REGISTERED Y/ N FEE CURRENT License # Y / N FEE CURRENT License # Y / N FEE CURRENT License # Y/N FEE CURRENT Y/N Address PLUMBER SIGNATURE COMPANY REGISTERED Y/N Address MECHANICAL SIGNATURE COMPANY REGISTERED Y/N Address OTHER SIGNATURE COMPANY REGISTERED Y/N Address License # 111II1111111111 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111I11111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal cfate. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stormwater 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. DI~~~ti~~~': . 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 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 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 AlC Fences (Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW