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esia-�nu-vu[u t;ity ot Lephymiils Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Recefved Phone Contact for Permittin C��,3 �0 __ Z-��� <br /> Owner's Name � � �' <br /> � �� «- Y`!'��'� �- Owner Phone Number <br /> � OwnePs Address � i-{- M w Owner Phone Number � —1 <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> �OB ADDRESS "�tjp �� �I(�i �� �1� LOT� �� <br /> �J <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> IMORK PROP03ED B 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 0 STEEL [� <br /> I � a.._ " S � <br /> DESCRiPTION OF WORK C l D s f,� , ,,,�,r �. �;y,r-� - �,r - ��l � L.,�i ��,J � <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �✓]BUILDING S � VALUATION OF TOTAL CONSTRUCTION � ! ' `' � <br /> QELECTRICAL � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING a ,� <br /> � (�353 <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY �] OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � � � COMPANY ��j'f � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— <br /> ELECTRICIAN � � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Address License# <br /> L <br /> MECHANICAL ae ' ` i 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)sats of Buiiding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Mfnimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaGlitles 8 1 dumpster;Site Work Permit for subdivfsionsAarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)w�orking days after submittal date. Required onsite,Construction Pians,Stormwater Plans w1 Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> ""•PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer 8 Contractor sign back of appltcation,notarized <br /> If over 52500,a NoNce of Commencement Is required. (AIC upgrades over 57500) <br /> •• Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of AppllcaUon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />