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o io-io�-wtu c;ity oi Lephyrhiils Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin ��`^Z 2 Qrp __ z � � <br /> Owner's Name �'� �C �/� Owner Phone Number �(3"?�Z , t-{S(�7 <br /> Owner's Address � �'"� C��� �� Owner Phone Number �— —1 <br /> Fee 3lmple Titleholder Name Owner Phone Number —� <br /> Fee Simple Titlehoider Address <br /> JOB ADDRESS �j 1 �-{ `��« �J� �� <br /> LOT#� <br /> SUBDIVISION PARCEL ID�! <br /> �OBTAINED FROM PROPERTY TA7(NOTICE) <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT � SIGN O Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSEO USE Q SFR Q COMM � OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK s��vr.%� L �//�' � L.E' <br /> BUILDING SIZE SQ FOOTAGE� HEIt3HT <br /> QBUILDING S � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> 9 <br /> �PLUMBING a �c f oD � <br /> /� <br /> OMECHANICAL � VALUATION OF MECHANICAL INSTALLATION <br /> QGAS [_] ROOFING Q SPECIALTY �] 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 /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> PLUMBER COMPANY ` � S�i�l//G� �.yG�� �",�,�Y <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �S�� L(�3 O� �I�d�' e �( License# �/CG CJ 7�/ <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 Butlding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Mfnimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Pians w/Silt Fence installed, <br /> Sanitary Fadlftles d�1 dumpster;Site Work Permit fo�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 constructlon. <br /> Minimum ten(10)working days after s�mittal date. Required onsite,Constructlon Plans,Stortnwater Plans w/Silt Fence i�stalled, <br /> Sanitary Fadlitles 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet comp8ance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '""PROPERTY SURVEY requlred for all NEW constructlon. <br /> ,��,r„��.���.,,���.����...,. <br /> Directiona. '"'� <br /> Fill out applicallon completely. <br /> Owner 8 Contractor sign back of applipdon,notarized <br /> Ii over t2500,a Notice oi Commencement is required. (A!C upgrades over:7500) <br /> "' Agent(for fhe contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of ApplicaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plof/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />