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813-780-0020 City ot Lepnymnis re���n� r1NN���Q���,� <br /> Building Department <br /> Date Received � phone Contact for Permitting ��`? /� ` <br /> Owner's Name ��-/�^� Owner Phone Number <br /> Owner's Address 3 y��9 L / `�" Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��-� Q-c� d� LOT # �-----' <br /> SUBDIVISION ��� D(L�`-'+ PARCEL ID# ° ��Od` �- � D 7�D <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � N TALONSTR e REPAIR � SIGN Q MOVE [� DEMOLISH <br /> L�J <br /> PROPOSED U5E 0 SFR 0 COMM � OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK + � � FRAME 0 STEEL Q OTHER <br /> DESCRIPTION OF WORK '�' ���I � � b� WD(� �� <br /> BUILDING SIZE � 7 � y7 ' SQ FOOTAGE �-� (R HEIGHT <br /> � BUILDING $ f 9� . tp VALUATION OF TOTAL CONSTRUCTION � I�L�� / <br /> J� J <br /> � ELECTRICAL $ � O� �� AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> �] PLUMBING � �'AS� PERMITSERV�CE <br /> 300 . d0 �8�3 <br /> VALUATION OF MECHANICAL INSTALLATfON Fiv( �,��14 �� <br /> � MECHANICAL $ �--� . � " 1 <br /> � �S:�Z��C�� <br /> � GAS � ROOFING 0 SPECIALTY � OTHER �Q <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES QNO � <br /> BUILDER ^ 'A �� � COMPANY J ` S� - <br /> SIGNATURE /�u T'��� � F2EGISTERED Y/ N FEE CURRENT Y/ N <br /> Address Q. S �� � License # <br /> ELECTRICIAN ����� s a���' �(�•�� COMPANY �d' Y�/� �L���� <br /> SIGNATURE V/ REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address /� � �-� d X' l ' License # � <br /> PLUMBER ^ `'�L/((/L-W�J� ' �(�` COMPANY ^-� "'w � <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address �� �C /�-�' � • C . � ' License # <br /> MECHANICAL � ��� �� COMPANY 4./�r � �I�d (�-�1 /�- <br /> SIGNATURE y � ����/{�' �--�� � REGISTERED Y/ N FEE CURRENT Y/ N � <br /> Address � �� i`t L � ' License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRENT 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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsflarge 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 /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Wori< 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 construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over $2500, a Notice of Commencement is required. (AIC upgrades over $5000) <br /> *" Agent (for the contractor) or Power of Aftorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMiTi'ING (Front of Appiication Only) <br /> Reroofs Sewers Service.Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />