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813 - 780 -0020 City of Lepnyrnllis vermit /Application rax- oi rou -uuc <br /> Building Department <br /> (Odic 6 - 1 1 . 1,'135 <br /> Date Received - b Phone Contact for Permlttin! --/ 5 Z - ql c?to5 <br /> Owner's Name kjeisigY CO Pi% L A Owner Phone Number R/3 - 7g - 2 / 2 <br /> Owner's Address 3 6 3 5 0 "T i20 /) &J00 d Pt Owner Phone Number, - <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address • <br /> JOB ADDRESS 353s -L- rdl/dQO d Pc- Z-e Ph y h /)5 FL 3 33 yZ. LOT # <br /> SUBDIVISION '✓f t fi i A M n d PARCEL ID# O2 2- ( - 2 - O am -o ()too -n C SO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED I I NEW CONSTR ADD /ALT Q S IGN n MOVE n DEMOLISH <br /> l INSTALL REPAIR <br /> PROPOSED USE RI SFR n COMM 1 1 OTHER 1 1 <br /> TYPE OF CONSTRUCTION BLOCK 1 1 FRAME n STEEL n OTHER 1 1 <br /> DESCRIPTION OF WORK ReP / 6 e. 3 wi&StJ,_ j tAN , ?LS 5 - 2-e- IS 2-e 'L SS <br /> BUILDING SIZE - SQ FOOTAGE HEIGHT <br /> BUILDING $ 77q / r O VALUATION OF TOTAL CONSTRUCTION <br /> 1 1 ELECTRICAL $ Q AMP SERVICE , 1 1 PROGRESS ENERGY 1 1 W.R.E.C. <br /> - <br /> n PLUMBING $ <br /> E1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> n GAS 1 1 ROOFING 1 1 SPECIALTY n OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 OYES 1 NO <br /> , -269- - .S .,.iicA <br /> ►� 1 i f titer An +h A # air 44 2 <br /> BUILDER COMPANY 6 ( er1 +eft L' <br /> SIGNATURE 11 � " REGISTERED FEE CURRENT Y IN <br /> Address S5A9 S S5fe +30 Ch(lethcio,R, 3201 License # leie i500+1 1 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED l Y/ N 1 FEE CURRENT l Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED l Y/ N 1 FEE CURRENT l Y/ N 1 <br /> Address ' License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N 1 FEE CURRENT 1 Y/ N 1 <br /> Address. License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT 1 Y/ N 1 <br /> Address License # <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 w1 Silt Fence Installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects <br /> COMMERCIAL Attach (3) sets of Building Flans; (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/ 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 NC Fences (Plot/Survey /Footage) . <br /> Driveways -Not over Counter If on public roadways..needs ROW <br />