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°"-""�"""' C:ity ot Lephyrhilis Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin �.� �� __�^� <br /> Owners Name ��2.� .q/ L.L' j�a` ��� /� <br /> ` T� Owner Phone Number <br /> Owner's Addresa � �� S � <br /> Owner Phone Number <br /> Fee Simple Titleholder Name <br /> Owner Phone Number <br /> Fee Simpie Titleholder Addresa <br /> JOB ADORESS �� <br /> LOT�t <br /> SUBDIVI310N PARCEL ID�I� <br /> B (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED NEW CONSTR ADD/ALT �� SIGN � Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDiNG SIZE SQ FOOTA(iE� HEIGHT <br /> OBUILDING a <br /> VALUATiON OF TOTAL CONSTRUCTION <br /> QELECTRICAL S AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a � � � <br /> n � y <br /> MECHANICAL S 7 VALUATION OF MECHANICAL INSTALLATION / <br /> J v� <br /> OGAS [� ROOFING [� SPECIALTY [� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas 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 /> Addreas <br /> License# <br /> MECHANICAL COMPANY �4 ,G S ��a � lj,�S� � f <br /> SIGNATURE RECaISTERED Y/ N EE CURRE� Y!N <br /> Address License# G � � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# —� <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit tor new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructfon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciNties 8 1 dumpster.Sfte Woiic Permit for all new proJects.All commerc(al requirements must meet compliance <br /> SIGN PERMIT Aftach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW constructlon. <br /> „�,i��������„��,�����„�.�. <br /> Directions. "`� <br /> Fill out appliption completely. <br /> Owner 8 Contractor sign back of applicadon,notarized <br /> If over 52500,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 wtth notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Appllcatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..needs ROW <br />