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a�3aso-oo2o Gity ot Lepnyrnins re������ � � i��� ( <br /> Building Department � <br /> Date Received <br /> � Phone Contact for Permitting j�`� �` -- `� �/� <br /> Owner's Name Qa.�/L � cfu �l�'�' <br /> �C ��� Owner Phone Number a � ��`�'� �/ <br /> Owner's Address � P3y �L v Owner Phone Number <br /> Fee Simple Titleholder Name <br /> Owner Phone Number <br /> Fee Simple Titleholder Address <br /> �C LOT # �� <br /> JOB ADDRESS 3p3S1 62tca <br /> SUBDIVISION ��tJ�"� ��`�'"'d � PARCEL ID# e�-� "" o�Gt �"'����� BD! d d ���d <br /> - v (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT � SIGN 0 MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � <br /> SFR 0 COMM 0 OTHER • � <br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL � OTHER --� <br /> DESCRIPTION OF WORK hO�/� a--�* • � O� d/Vr ��Q�" <br /> BUILDING SIZE LT x� � SQ FOOTAGE Sl0 HEIGHT <br /> � BUILDING $/ s . p�p � VALUATION OF TOTAL CONSTRUCTION <br /> / < <� <br /> � ELECTRICAL �$ � DO' � � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> � PLUMBING $ �oo aa PA �(813) 788.631� <br /> • VALUATION OF MECHANICAL INSTALLATION �� �-��' M7$� <br /> � MECHANICAL $ on � p0 <br /> V <br /> � GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES ONO <br /> . � � t� COMPANY �� � �U� �`C • <br /> BUILDER 1 ����� . ` <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> � � COMPANY COW �� � ��� � �� <br /> ELECTRI�I � <br /> SIGNATURE � REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> PLUMBER <br /> x � . COMPANY � V�� L� � <br /> SIGNATURE �� REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> MECHANICA <br /> � COMPANY ������� � ¢� <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y! N <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> RESIDENTIAL Atlach (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 /> .. _ . .. ..� _._ _ r..__�..._a__ n�....._ .../ ctl4 C.,r...o �nck�llor� <br />