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813 780 - 0020 Gity of Lephyrhiils Fermit Application rax- C 1j- iuu -uuz, <br /> Building Department <br /> Date Received / — — // I S ) — I <br /> Phone Co tact for Permitting <br /> Owner's Name �; � Ny L a Owner Phone Numb I ,_________2_,___2_._., <br /> _1 <br /> Owner's Address •. + � r ' '_ 4 Owner Phone Number 1 <br /> Fee Simple TitijotdeNa e . tip jVj ` �' �`_: ', I <br /> Phone Number <br /> Fee Simple Titleholder Address ( <br /> JOB ADDRESS � j / 7/r) , `/- - LOT # I <br /> SUBDIVISION 1 <br /> I , PA CEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED I I NEW CONSTR n ADD /ALT � � SIGN r [ DEMOLISH <br /> INSTALL 17 REPAIR <br /> PROPOSED USE ri SFR n COMM I I OTHER 1 I <br /> TYPE OF CONSTRUCTION n BLOCK ri F ME I 1 STEEL n 1 I <br /> DESCRIPTION OF WORK 1 ' 01- �k49 e S I <br /> BUILDING SIZE 1 1 SQ FOOTA 1 HEIGHT I <br /> n BUILDING 41 - '1"—,^ J �— <br /> V VALUATION OF TOTAL CONSTRUCTION <br /> F $ <br /> ( I AMP SERVICE I 1 PROGRESS ENERGY_,... W.R.E.C. <br /> nPLUMBING I$ I i/Ii-/7/ <br /> n MECHANIC ' L I$ I VALUATION OF MECHANICAL INSTALLATIO <br /> El GAS [ ROOFING rl SPECIALTY I I OTHER <br /> FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA nYES NO <br /> BUILDER <br /> I <br /> I COMPANY I I <br /> SIGNATURE REGISTERED Y / N FE E CURREf <br /> I I Y / N I <br /> Address 1 License # I I <br /> ELECTRICIAN I COMPANY 1 I <br /> SIGNATURE I REGISTERED FE E C <br /> I Y / N URREN I Y/ N I <br /> Address 1 License # I I <br /> PLUMBER I COMPANY I I <br /> SIGNATURE I REGISTERED FE <br /> I Y / N I E CURREN I Y/ N I <br /> Address I License # I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y / N FEE CURREN �� <br /> Address „ d fin / <br /> ••� •� M <br /> cense <br /> OTHER ���� ����� W5� ' %1��� � <br /> ■ COMPANY ��� ► <br /> SIGNATURE k � A REGISTERED ' �� E s'! - Y / N <br /> Address <br /> 11111►� = <br /> •IPRsW#Aglm1 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 w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br /> 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. <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 $7500) <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 if shingles Sewers Service Upgrades NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />