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airinu-uuzu c:iry ot Lephymills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received �� — /� Phone Contact fo�Permittin -- <br /> Owner's Name iG .� �- <P•-� Owner Phone N 'ber �/` �--..._ <br /> ` �__ " �.�r.��'-�?�.� <br /> Owner's Address 0� T��r �S Owner Phone Number /,u� /Q��y� <br /> Fee Simple Titleholder Nama Owner Phone Number C � <br /> Fee Simple Titleholder Add►ess � <br /> JOB ADDRESS /�// (� � ST�� LLS , LOT# �-�6S <br /> SUBDIVISION PARCEL ID* �— - �"Od/4 �C�/DoQ —GC�/j� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT Q SIGN Q C] 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 �G(�/�//�C� /iY/S T Ll� <br /> BUILDIN(3 SIZE SQ FOOTAGE � OD HEIGHT / S'T6�= <br /> �BUILDING �-- � VALUATION OF TOTAL CONSTRUCTION '� / S ° O(� <br /> QELECTRICAL S AMP SERVICE Q PROGRESS E'NERGY Q W.R.E.0 <br /> OPLUMBING a 3�a <br /> QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> � �� <br /> OGAS Q ROOFING Q SPECIALTY Q OTNER <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO <br /> BUILDER ' � COMPANY �� ��/U�I�--/ <br /> SIGNATURE REGISTERED Y! N FEE CURREI� Y/N <br /> Address License# C <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N fEE CURREn Y/N <br /> Address License# C <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License# C <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURREI� Y/N <br /> Address License# � <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y! N FEE CURREI� Y I N <br /> Addross License# C <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 Fadlitles d�1 dumpster;Site Work Permit for subdivislonsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans pius a Lffe Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructfon. <br /> Minimum ten(10)working days after submittal date. Required onsfte,Construction Plans,Stormwater Plans w/Siit Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Woric Permit for all new projects.All commercfal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ••••PROPERTY SURVEY required for all NEW constructlon. <br /> Directiona: <br /> Fill out application completely. <br /> Owner 8 Co�tractor sign back of applfcatlon,notarized <br /> If over i2300,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> •• Agent(for the 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 AppllcaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..needs ROW . � <br /> s <br />