Laserfiche WebLink
oio-iov-w�u c;ity ot[ephymilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> DateReceived •����� <br /> Phone Contact for Permittin �'/ 3 8� __ ,S6 �Z <br /> Owner's Name /�Mo� ,S(JI�M�� �L Owner Phone Number <br /> Ovmet's Address 3�' �3� 7�`,� �v� � <br /> Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee 3lmple Titleholder Address <br /> JOB ADDRE33 LOT# �� <br /> SUBDIVISION PARCEL IDA! f�-2 fo �'2/_ U G/p� �23UG_ �G Ic�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> VMORK PROP03ED B NEW CoNSTR ADD/ALt � SIGN Q Q DEMOLISH <br /> INSTALL ,� REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CON3TRUCTION [� BLOCK Q FRAME [��] STEEL Q <br /> r /�- <br /> DESCRIPTION OF WORK �"�ig/�c/ L /N�C / €NC�� �' �T��' <br /> BUILDIN(i SIZE 3Q FOOTAGE �� HEI(iHT � <br /> [�..�BUILDING a <br /> ���� c, VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL � AMP SERVICE Q PROGRESS ENERGY •� iN.R.E.C. <br /> � <br /> OPLUMBING a /`� <br /> / <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION f � � � <br /> / � <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> -�,, <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY �C a Cc�,/u��/ �o ��✓ r <br /> SIGNATURE � REGISTERED / N FEE CURRE� Y N <br /> Address License# <br /> EIECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License# � <br /> MIECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# —� <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURREP Y/N <br /> Addreas License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days aRer submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Lffe Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon. <br /> Minimum ten(10)wo►king days after s�mittal date. Required onsite,Conshucdon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadflUes 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 required for all NEW construcdon. <br /> Directlons: <br /> Fill out applfcaHon completely. <br /> Owner 8 Contractor sign back of applicatlon,notarized <br /> If over SZS00,a Notice of Commencement is required. (AIC upgrades over s7500) <br /> " Agent(for the contractor)or Power of Attomey(for fhe owner)would be someone wlth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI'TTING (Front of AppHcaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plof/Survey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />