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813-780-0020 City ot Lephyrnil�s rermit Hppucauon rax-o�riou-w�� <br /> _ Building Department <br /> Date Received Phone Contact for Permittin - <br /> Owner's Name �, s Owner Phone Number 35Z � �� 2-- <br /> Owner's Address �� +^'� � Owner Phone Number <br /> Fee Slmple Titleholder Name � Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � s i( l /' LOT # � <br /> SUBDIVISION � , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK �'^�( i✓� C <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE �d� � PROGRESS ENERGY Q W.R.E.C. <br /> , f �� <br /> QPLUMBING $ /� � ( <br /> QMECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # �— � <br /> ..�- <br /> ELECTRICIAN COMPANY � /� � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address V f � 3 � 3.� 5 License # /,3 D�f3 �3� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address Ucense # � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Ucense # —� <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 Pians; (1) set of Energy Forms; R-O-W Permit for new constructlon,, <br /> Minimum ten (10) working days after submittal date. Required onsite, ConstrucUon Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large p�ojects <br /> COMMERCIAL Attach (3) comptete sets of Bullding Plans plus a Ufe Safety Page; (1) set of Energy Forms. R-O-W Permit for new consVuction. <br /> Minimum ten (10) working days afler submittal date. Required onsite, ConstrucGon Plans, StoRnwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 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 constructlon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application, notarized <br /> If over;2500, a Notice of Commencement is required. (AIC upgrades over s7500) <br /> *' Agent (for the contractor) o� 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 A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW /� � d � v 0� 3-� a d�� o <br /> � z �° Z <br />