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rdx o i 3-1 ov - vuc.i <br /> 813 - 780 -0020 City of Lephyrniiis Farm Farm Application 1t 139 <br /> Building Department J <br /> (1'lorv1C6. <br /> Date Received <br /> Phone Contact for Permitting 3 2/ c -- 9b5 <br /> i v Gso <br /> Owner's Name 5 I u eiro 12...-e_ /\ � i I cos.) ft- A) Owner Phone Number ?I3 7 QD ° <br /> Owner's Address S /3 6 S,, 'i'----& /{-,. ii D/2_ Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address c� 1 <br /> JOB ADDRESS S /3/, JL.j,-r, ,'i cn 79 t i 02 -- t /1 /(S fl--- 3 3SY2- LOT # Z‘ <br /> SUBDIVISION 5(AM i-e,L (-r'. ti PARCELID# 1 2--- 2 --2/- 0 /DO -OCC )ce -pz 6 B <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT 1 I SIGN I 1 MOVE I 1 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 1 1 SFR 1 1 COMM n OTHER <br /> TYPE OF CONSTRUCTION 1 1 BLOCK I 1 FRAME / L STEEL I OTHER <br /> DESCRIPTION OF WORK --f—(J .5-1-4 I 1 7S 1 O 6 I /f 9& t:edJc e_ fea,--i <br /> BUILDING SIZE ° SQ FOOTAGE HEIGHT <br /> BUILDING $ VALUATION OF TOTAL CONSTRUCTION 1 r 37, ) / <br /> ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERGY 1 I W.R.E.C. <br /> I PLUMBING $ <br /> 1 I MECHANICAL $ • VALUATION OF MECHANICAL INSTALLATION <br /> I GAS I I ROOFING 1 1 SPECIALTY n OTHER <br /> FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA I IYES nN0 <br /> All + <br /> Fei h (Ai-curb II <br /> BUILDER e-1r + I' / <br /> SIGNATU -"M. � �" MPY � f t l7 11 r C PXI +e• r -el e ' <br /> , <br /> ` REGISTERED COAN S N 1 FEE CURRENT L Y / N <br /> Address - 2-q :, • tr7,efG� L,.2 %TF y 3 't0 c .i21 c, FL I License # L�C l <br /> ,{�J L{ (—� <br /> 3Z U <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N . 1 FEE CURRENT I Y/ N I <br /> Address I I License # I <br /> PLUMBER I COMPANY 1 <br /> SIGNATURE REGISTERED 1 Y/ N FE E CURRENT URRENT I Y / N <br /> Address 1 License # I <br /> MECHANICAL I COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N <br /> 1 FEE CURRENT I `ON I <br /> Address I I <br /> License # <br /> OTHER I COMPANY I <br /> SIGNATURE REGISTERED 1 Y / N <br /> I FEE CURRENT I Y/ N I <br /> Address I <br /> 1 <br /> License # I <br /> RESIDENTIAL 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 onsite, Construction Plans, Stormwater Plans w/ SIR Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects <br /> COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R -O -W Permitfor new construction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new protects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> -**** PROPERTY SURVEY required for all NEW construction. ' <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. (NC upgrades over $5000) <br /> " Agent (for the contractor) or Power of Attomey (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 Fences (Piot/Survey /Footage) <br /> Driveways - Not over Counter If on public roadways..needs ROW <br />