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813-780-0020 City ot Lephyrnilis t�ermit Appucation rax-esis-iuu-vun <br /> ` Building Department <br /> Date Received / <br /> " !' � Phone Contact for Permittin -.---------- <br /> Owner's Name ��' r/ 4 � S r'r� e s� Owner Phone Num r �l 3� 7�3 - 973 �` <br /> Owner's Address 3��'6 La.rs i n �„�e, �� .�/T;lls R>'3S`� Owner Phone Number <br /> Fee Simple Titleholder Name YOr� a�-d Sh i' i n�/' Owner Phone Number ��3 — 7� ' Y 7 3 6 <br /> Fee Slmple Titleholder Add�ess <br /> JOBADDRESS 3�7 �anS /�i �.�e. e�i � b�'�l L 33Sy2 LOT# � � <br /> SUBDIVISION x�epy /�oG�ow �'Ic6•�e , PARCEL ID# <br /> (OBTAINED FROGI PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN 0 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK E Gct c� � GU �� •-! c9 vr.vs' l/J 0 i L� o•�+ �- <br /> BUILDING SIZE �/�D SQ FOOTAGE� HEIGHT �—� <br /> �BUILDING $ L�� VALUATION OF TOTAL CONSTRUCTION <br /> � <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ � � /�� � <br /> I <br /> QMECHANICAL � VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS OOD ZONE AREA QYES NO <br /> �UILDER � yG%Yy p / p Q COMP�Y <br /> SIGNATURE zr,� �%�l REGISTERED Y/ N FEE CURRE� Y I N <br /> Address ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <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 License # � <br /> OTHER COMPANY <br /> SIGNATURE 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 construction,. <br /> Minimum ten (10) working days after submittal date. Required o�site, Constructlon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisions/large p�ojects <br />