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esis-inu-uu�u C;ity ot Lephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin __ <br /> Owne�'s Name ��"1 Q,f��'�. Owner Phone Number <br /> Owner's Address r �� �"'()h �'�n�� , �J�j pwner Phone Number —� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS U �.�,.C(�U J . � � 1 I L� ��J LOT# C� <br /> SUBDNISION YV � PARCEL ID� � 'Z(,�'"Z� - �pU- _ � � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> VUORK PROPOSED NEW CONSTR ADD/ALT �� SIGN Q Q DEMOLISH <br /> INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK S�t �� �('��d� ���� <br /> BUILDING SIZE �--� gq FOOTAGE[LZ:1..i�1J HEIGHT <br /> QBUILDING $ � ��l - VALUATION OF T07AL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE 79�0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a ��Q�� �� <br /> � -�b� <br /> � <br /> OMECHANICAL S V TION OF MECHANICAL INSTALLATION <br /> GAS � ROOFING Q SPECIALTY � OTHER <br /> FINISHED OOR ELEVATION FLOOD 20NE AREA QYES NO <br /> BUILDER ,� _ COMPANY ' .{� (`��, �(' L�� <br /> SIGNATURE — '– REGISTERED Y N FEE CURRE� Y/N <br /> Address License# L.J�.-+.-���$ �3�� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Add►ess License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas Ltcense# <br /> MIECHANICAL 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 /> Address License# � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W PeRnit for new construction, <br /> Minimum te�(10)working days aRer submittal date. Required onsite,Construction Plans,Stonnwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles 8 1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Athach(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 aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compifance <br /> SIGN PERMIT Attach(2)sets of Engineered Ptans. <br /> """PROPERTY SURVEY required for all NEW consVuction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applicatlon,notartzed <br /> If over 52500,a Notice of Commeneement is required. (AIC upgrades over E7500) <br /> •• Agent(for the contract or a}"ftttl'jm�ly( e someone wtth n letter.fror[�owner authorizing same <br /> ��„ <br /> OVER THE COUNTER PE (TTING (Front of AppllcaUon,Otily) <br /> Reroofs if shingles S � Service Upgrades A/C . (PIoVSurvey/Foo e) <br /> , � �'". <br /> Driveways-Not over nt�r if on public roadways..neelia�N/ �� ' ;��; <br /> , ,�,r'�. <br /> � �"`N"�• ���"IYG:- �.�� R f <br /> i"`"�n+�� <br />