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<br />813-780-0020 <br /> <br />t;ity ot Lepnyrnilis permit AppliCatiOn <br />Building Department <br /> <br />ri:lx-o 1':>-' OU-UU":.I <br /> <br />Owner's Address I 5:320 <br />Fee Simple Titleholder Namel <br /> <br /> <br />j'- \5 -0<6 <br />'\~ \,.J S. <br />SA--t!5 CA /YI A <br /> <br /> <br />Date Received, <br /> <br />0/<- <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />SUBDIVISION <br /> <br />I <br />532G::. <br />2.. J-I.-r s <br /> <br />LOT # <br /> <br />let <br /> <br />S'A-r5.....rY\,tt- Da.'Z-eI'A"f(7./" II~ FI :3'.15V2..1 <br /> <br />I PARCEL ID#I J 2. - Z'- -2/- OOy.l) '-a?:3~ - 0090 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D NEW CONSTR c:::J ADD/AL T D SIGN D MOVE D DEMOLISH <br />D INSTALL c:=:J REPAIR <br />r-:::l-- SFR ~ COMM 0 OTHER I <br />PROPOSED USE L...::J L-..J <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME D STEEL D OTHER I <br /> <br />DESCRIPTION OF WORK I ~P{AG2..- 1 OOC>!2- S(~ /'51 ~ ' <br /> <br /> <br />Er~~~~~;~~I"""", i;"""""" ,I"" ,~~ ~~T~! ~~~~~:~~'~~ ;~;~ :~:::~L,", /::3 V~' ':" ?;~..""'."" , <br /> <br /> <br />o ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY ~ W.R.E.C. <br /> <br />o PLUMBING 1$ I ;J 00 - N I Pc <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I <br /> <br />J S-r A./4' <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />~~~~i~~' <br />-.. ._~ H""'CURRENT I Y/N" <br /><2.l5 ()gLf-f -, <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />FEE CURRENT <br /> <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />License # <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 />I Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />License # <br /> <br />f111111111111111111111111111111111111111111111111111111III1I11III1111I1I1I11I111I1I11I11I11I1I1II11I111I11111I1I11111I11I1I1I111I1 <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction. <br />Minimum ten (10) working days after submittal date. Required onslte. Construction Plans, Stormwater Plans w/ Sill Fence Installed. <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslonsllarge projects <br />Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit lor new construction. <br />Minimum ten (10) working days IJftar submittal :Jate. Rec:;ulred onslle. Construction Plans. Stormwater Plans wI Silt Fence Installed. <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. . <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMMERCIAL. <br /> <br />SIGN PERMIT <br /> <br />,."....,.,.....,.........,.,..."...".,....,..."."......,',.,..........,.."....""."..,.,..,...,.,..,.....,.......""..............".,... <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 Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />