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��3-�n�-uu�u t;iry ot Lephyrt�ills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin __ <br /> Owner's Name Owner Phone Number /$�' g°Z�� <br /> Owner's Address ��"T�� 'Jr�n /�+�'. Owner Phone Number � g� g'2�'� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS ��- LOT� � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> INORK PROPOSED e NEW CONSTR 8 ADD/ALT [� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM �] OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK Q-i.�.�" � �l p�I R�c= <br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT <br /> QBUILDING s VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.0 <br /> QPLUMBING � <br /> ( `��`� <br /> �MECHANICAL s 3 i a� ��, VALUATION OF MECHANICAL INSTALLATION � J <br /> OGAS Q ROOFING Q SPECIALTY Q 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 License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �- <br /> MECHANICAL � j� COMPANY ��@���� � <br /> SIGNATURE �' � REGISTERED N FEE CUR E� <br /> Address 3�.�..7 �SIK /P�I License# �/4'��v 1..�'��� � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addross License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sats of Bui�ding Plans;(1)set oi Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stonnwater Plans w/Silt Fence installed, <br /> Sanitary Facllitles 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Buflding Plans plus a Lffe Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)workirx,�days after submittal date. Required onsfte,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Factlities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compNance <br /> SIGN PERMIT Attach(2)sets af Engfneered Plans. <br /> '•"•PROPERTY SURVEY required for all NEW constructlon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commeneement is required. (AIC upgrades over 57500) <br /> •• Agent(for the conbactor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTE�PERNHTTIN6 (F`ront of Applicat�on Only) <br /> Reroois if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Orivewaya-Not wer Counter if on pubHc roadways..needs ROW <br />