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�,�-�nu-�u�u c.:ity ot Lephyrttills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received -,�j-'� Zi Phone Co�tact for Permittin � z 7 `("� / __ S �� <br /> Owner's Name ����r R � S � Owner Phone Number <br /> Owners Address Owner Phone Number <br /> Fee Simple Titleholder Name —� Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �E� S CG r� �� <br /> � � � � LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEw CONSTR 8 ADD/ALT Q SIGN [�� 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 �1.� ( ( � �,1. �G( e �� <br /> � c.��r�t �e- �. S 6��� � , <br /> BUILDING SIZE SQ FOOTA(3E�� HEIGHT <br /> OBUILDING a� VALUATION OF TOTAL CONSTRUCTION <br /> � �lr�'. 6> <br /> QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0 <br /> QPLUMBING a <br /> � � �`( 1�I <br /> �� �('/11.��/L <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ��� ' ��z • <br /> ,��,� ��- � <br /> �9 � <br /> QGAS Q ROOFING Q SPECIALTY �] OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �`�'L��U� <br /> � <br /> � <br /> BUILDER J ' � � COMPANY �C''��c�i��-c�� c�2 r'�c- �� � :.� <br /> SIGNATURE i' �.��-u� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address /��!� Ye��?✓!�� � � �t����( � y /-��5��-� � �+- C�(a� �� <br /> � License!� �� <br /> ELECT COMPANY <br /> SIGNA R REGISTERED Y/ N FEE CURRE� Y J N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreaa License# �— —� <br /> NIECHANICAL 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 /> Addross License# � <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&1 dumpster;Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Ufe Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construcdon Plans,Sto►mwater Plans w/Silt Fence installed, <br /> Sanitary Facflities 8 1 dumpster.Site Work Permit for all new projects.All commerciai requirements must meet compUance <br /> SIGN PERMIT Atfach(2)sets of Engineered Plans. <br /> ••••PROPERTY SURVEY requlred for all NEW construcdon. <br /> DirecHons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of applicatlon,notarized <br /> If over=2500,a Notice of Commencement is required. (AIC upgrades over=7500) <br /> •' Agent(for the contractor)or Power of Attomey(for the owner)would be someone wfth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITT�NG � {�rqnf of A�'plft:3tltm'Onlyr- <br /> Reroofs ii shingles Sewers ; Senrice Upgrades pl/C �nces(PbVSurvey/Footage) <br /> : ,,;� ' +� <br /> K <br /> Driveways-Not over Counter if on pubflc roadways..needs ROW ! <br /> .. ,.._ _ . . ,.c <br />