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813 - 780 -0020 UIty of Lepnyrnills Hermit Application raA -o i o- I ov - vuc., <br /> Building Department <br /> ill D n; r C A o 7 Date Received r <br /> Phone Contact for Permittin ! �0(3 z6g -_ 9965 <br /> Owner's Name DAU-c_ Adio /Y'' S Owner Phone Number D c� r3 - 7 ko - /03 9 <br /> Owner's Address 621 / v TA S / 2 - 1i //S FL 3SS V2. Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ( -2 1 ) /) T7-1 ST 2-cPA y ahi, /ls Fz 3 3 'S LOT # 4 --/-F <br /> SUBDIVISION Z ph yR � f - e 2 � PARCEL ID# 0 V - - 2b - ; - . 6 — 0/9 — (9 D 05 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT I 1 SIGN ( J MOVE ( J DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 1 1 SFR ( 1 COMM ( 1 OTHER ( ( ,f't>4c.r.a .;.1v„T <br /> TYPE OF CONSTRUCTION 1 1 BLOCK J 1 FRAME ( ( / STEEL 1 1 OTHER <br /> DESCRIPTION OF WORK r2e42//)cE (S: (JSL .D00,2- (-1/J f 1 0o u6Ce. Lec,2 ,,,,, . 2 c/S, Z-v___ <br /> BUILDING SIZE • SQ FOOTAGE HEIGHT <br /> BUILDING $ /-\/ - / G'1 i •3. VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ /\ AMP SERVICE ( 1 PROGRESS ENERGY 1 1 W.R.E.C. <br /> ( PLUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> GAS J 1 ROOFING 1 1 SPECIALTY n OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ( JYES J JNO <br /> 131 <br /> Hetev <br /> BUILDER f � ' An-tin C1l- -c(-t.l�Z� <br /> c7 z ZDL / COMPANY <br /> SIGNATURE ' I-4-r) me Ceri +erg �viC <br /> REGISTERED FEE CURRENT <br /> 1 Y / N J <br /> Address 3S2_9SOA, vek Ste" L/36 ©2,j .4nrs1 License# C_6ACt.5O0+1 <br /> ELECTRICIAN /�L 3� C <br /> SIGNATURE REGISTERED J Y / N j FEE CURRENT J Y/ N J <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED J Y/ N J FEE CURRENT 1 Y/ N <br /> Address License # <br /> MECHANICAL 1 COMPANY <br /> SIGNATURE J REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N J <br /> Address I 1 License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y / N <br /> J ( FEE CURRENT J Y / N <br /> Address ( 1 License # l 1 <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -0 -W Permit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed, <br /> COMMERCIAL Attach (3) sets of Building Plans; (1) set of subdivisions/large <br /> Energy Forms.R i0- W new construction. <br /> Minimum ten (10) working days after submitta! date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. 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. (A/C 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 A/C Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter If on public roadways..needs ROW <br />