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uia-iou-uu�u C:iry ot Lephyrhiils Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date ReceiveQ S����' _. Phone Contact for Permittin -- <br /> � <br /> Owner's Name E � tiCJ � /9�� Owner Phone Number <br /> Owner's Address � �TS/Y-� �Q Owner Phone Number C � <br /> Fee Simple Titleholder Name Owner Phone Number C <br /> Fee Simpie Titleholder Addresa <br /> JOB ADDRESS �,2.-`f 2— �5��/!�� ] LOT# � <br /> SUBD�1/ISION L �R" f//L��'�' PARCELIDN �S � �1 BP,�D ��BI�� ��L� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK � ��� l7' W`�[' � Ti'T� �IO�/��`L�.7-� S/��'�d� ���� <br /> BUILDING SIZE SQ FOOTA(3E� HEIGHT �� <br /> QBUILDING S � � VALUATION OF TOTAL CONSTRUCTION <br /> � <br /> QELECTRICAL a AMP SERVICE Q PROGRESS E:NERGY Q W.R.E.C. <br /> QPLUMBING a <br /> , � <br /> QMECHANICAL $ VALUATION OF MECHANtCAL INSTALLAT N �?� .��,,.� �j ,j' <br /> }i �' <br /> QGAS �� ROOFING Q SPECIALTY Q OTHER �-••------'"�� <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NC) <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Addreas License# C <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRF� Y/N <br /> Address License# � � <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> OTHER C,��j COMPANY (l=9Q 1�/� OD�'�f�� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � 1� � L''� License# �/�C�p�t�-y� <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 w1 Sflt Fence installed, <br /> Sanitary Facllitles 8 1 dumpster;Site Work Pertnit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Buflding 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 submittal date. Required onsite,Conshuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciBties 8 1 dumpster.Site Work Permit for all new projects.All commerciai requiremenks must meet comp8ance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ••"•PROPERTY SURVEY requlred for all NEW constructlon. <br /> DirocNons: <br /> Fill out applicaHon completely. <br /> Owner&Conhactor sign back of applicaHon,notarized <br /> If over 52500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> •' Agent(for the conVactor)or Power of ABomey(for the ovmer)would be someone with nota�ized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TING (Front of Appiicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurveylFootage) <br /> Drivewaya-Not over Counter if on public roadways..needs ROW <br />