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813-780-0020 C:ity ot Lephyrhilis Nermit Application raX <br /> Building Department ' � � p� <br /> �l <br /> Date Recelved �- —�� phone Contact for Permittln �� 3 �� � _ GS 1 5 <br /> Owner'sName � - hc.,(Zle 5 R� � OwnerPhoneNumber �l3 ���i� <br /> Owner's Address �Sd9 � ����� Owner Phone Number � I a� '� v� 6 `�� � <br /> Fee Simple Titleholder Name � Owner Phone Numbar �— <br /> Fee Simple Tltleholder Address <br /> JOB ADDRESS 5� a �� S�= LOT # C� <br /> SUBDIVISION , PARCEL ID# � ( - a 6 ' °2 � - �'�. I o - � �c� � - C (C30 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR � ADD/ALT � SIGN �] [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �� N�vu� Guc� (Z,�t I�A�+ S`r��.��� v hPC) . <br /> BUILDING SIZE �����/ X a � 1 SQ FOOTAGE � y 3 HEIGHT �� <br /> [t7�BUILDING $ � VALUATION OF TOTAL CONSTRUCTION <br /> °� � 35 . � <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �]GAS Q ROOFING Q SPECIALTY [� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER �: ���' 1 �, COMPANY ��� C� H���cN �c'v.S'1'�wG�'i� �v 2►,iC . <br /> SIGNATURE REGISTERED / N FEE CURRE� N <br /> Address �`� �� Q�t 5 �Q � �P .v <br /> R� , License # G$�� �{770� S —� <br /> ELECTRICIAN � A" � r � COMPANY '✓" � �4 5,5� �C �� / �� C� <br /> SIGNATURE ° �` REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ,� ( � � License # �C �3c%3�Z-j�'"� � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Ucense # � <br /> OTHER COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/ N <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 wnstruction,. <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Pefmit fOr subdivisionsparna nrniwrtc <br />