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813- 780 -0020 City of Lepnyrnllls rem'''. /Applt,au 'ii 1 Building Department /-4 y 7G D / 7 a/T �. 1°8° 1 Date Received ' V 2-(9-10 Phone Contact for Permitting [/ 7» -- -- Owner's Name 4) ay/P9--- t WV— Owner Phone Number Owner's Address 3! VO i_etUte/ r age i tgho/ Owner Phone Number Fee Simple Titleholder Name Owner Phone Number Fee Simple Titleholder Address LL!! / '�r (_/ 8� / Z / JOB ADDRESS 3 E TV L le/ v L/� UQ `r LOT # tt>2-- SUBDIVISION /' Z te act.,4f. a 4 PARCEL ID# a- --.524 --.524 - dMod - oo /co - O p C) (OBTAINED FROM PROPERTY TAX NOTICE) WORK PROPOSED NEW CONSTR ADD /ALT f I SIGN 1 I MOVE I I DEMOLISH INSTALL REPAIR PROPOSED USE E SFR 1 I COMM I I OTHER I I TYPE OF CONSTRUCTION I I BLOCK I I FRAME [ I STEEL I I OTHER I I DESCRIPTION OF WORK Ch-2 / Cr „A ,' &VA 7 C44 BUILDING SIZE / CL )( 3y SQ FOOTAGE 4 1 DO HEIGHT IV BUILDING $ q 762S 619 VALUATION OF TOTAL CONSTRUCTION �7 1 I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I I W.R.E.C. /00 PASCO PERMIT SERVICE PLUMBING $ �t,' �' FA X 7$8 -5314 I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1-888-824-7894 I I GAS 1 I ROOFING [ I SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES I INO SIGNATURE BUILDER w G�b'-'��- 1 1 75 010 R COMPANY $ -( 1 v +" ° � CURRENT / N C -1 Address GA / C - 6/-7 1 -- K_ /2- ci .-1 1€-§ i License # C' Ac,0 s6 517 ELECTRICIAN COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y / N I Address License # PLUMBER COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I Address License # I MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I Address License # OTHER COMPANY SIGNATURE REGISTERED I Y / N I FEE CURRENT I Y/ N I Address License # 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 date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction. Minimum ten (10) working days after submittal date. Required onsite, 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. • Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (A/C 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 A/C Fences (Plot/Survey /Footage) Driveways -Not over Counter if on public roadways..needs ROW