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813-780-0020 City ��t Lephyrhiu: Nermit Application Fax-S73-I8U-UUZ1 <br /> Building Department <br /> Date Received _ � � ' � � Phone Contact for Permittin � � � / 7 — � <br /> Owner's Name l� R Pif �� Owner Phone Number lJ� o d��7 <br /> Owner's Address 3 8/ l� �-l�F- Q�� 2 h l�l/�IS� ��-���ner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simpie Titleholder Address <br /> JOB ADDRESS � IO / �/ A' �- /� LOT # � <br /> SUBDIVISION � PARCEL ID# ��' - - O" OO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ���J � e2i p�2 �q <br /> BUILDING SIZE SQ FOOTAGE ��I.Z C� HEIGHT <br /> QBUILDING $ L�/� � UU� VALUATION OF TOTAL CONSTRUCTION � I I�I Q� <br /> � <br /> QELECTRICAL $��� A P SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> ����'` � <br /> QPLUMBING $ � �� S.Q�'� <br /> 3-IS <br /> QMECHANICAL $ O � VALUATION OF MECHANICAL INSTALLATION `" `/� ,�y f t <br /> � � ,� ����� 5 <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER /� , J�) � <br /> l�G!� �v <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <br /> BUILDER / COMPANY / Cv F/C� N.r R tj C i '�-r't/ <br /> SIGNATURE FiEGISTERED Y/ N FE rtitEn Y/ N <br /> Addr s � ' "'� <br /> License # (� <br /> ELECTRICIAN � COMPANY �l uS F" £Z-�yCL L�C • <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y N <br /> Address (�{ 2 7 $�' � � 3 2 3 3S�'Z3 License #� d( S'�( �/ <br /> PWMBER '�-�- �� COMPANY � � �C l � � � LL ►'1� '"' �y�,C <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address v�7� � Vt 0i�s� n-� 3X License# ���C'����� <br /> 1 <br /> MECHANICAL COMPANY a��{� e a� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � Q � �� �c UCense # �JtL' �8/3,s 7 �_ <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 wnstruction,. <br /> Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence instalted, <br /> Sanitary Facilities 8 1 dumpster; Site Worlc Permit for subdlvisionsllarge projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Llfe Safety Page; (1) set of Energy Forms. R-O-W Permit for new construcaon. <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 requlred for all NEW construction. <br /> IIITIIII71111�IITIr <br /> 1�.raa 1 1 iai�l li 1 1 i 1 1 � {J11 11 I <br /> Directions. <br /> Fill out application completely. <br /> Owner & Confractor sign back of applfcatlon, notarized <br /> If over;2500, a Notice of Commencement Is required. (A/C upgrades over s7500) <br /> '* Agent (for the contractor) or Power of Attomey (for the owner) would be someone with n <br /> OVER THE COUNTER PERMITTING Front of ?''`• ''''"' '��� �;:- <br /> ( APPIIcation Only) b�,nN -, 4tc;.' ,+au� Y;rym�^ , y�t., <br /> Reroofs if shingles Sewers Servlce Upgrades A/C Fences (Plot/Survey/Foota � <br /> �f4S ,r' •0!1 7�t>�,.� : ,tt��.? �s'N' : �� � <br /> Driveways-Not over Counter if on public roadways..needs ROW �'�t;'E 3'� �''="z'•""F" i '"?,�, �;` <br /> rtaa# q�s1oY! �notk.,t ,',;,, � � ` ��+ aA ',,;,".d9,.�' <br />