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n,o-�ou-uu�u t;iry ot Lephymills Permit Application Fax-813-780-0021 <br /> Building Department ,, ���� <br /> ��. <br /> Date Received �_ �_l'�/ .� <br /> ( Phone Contact for Permittin � � _ <br /> Owner's Name C 1��, �, W i'�UCY S ��--3d r°G O� <br /> Owner Phone Number 7 <br /> Ovirner's Address s�'� S� �7-: � ,� �� �;3S- p�er Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS .�,-3`] �T�` �T �.��H. � y��- `��,� ?� 35�1� �d�� LOT# � <br /> SUBDNISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> VNORK PROPOSED NEW CONSTR ADD/ALT [_] SIGN [� Q DEMOLISH <br /> INSTALL e REPAIR <br /> PROPOSED USE � SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME [�] STEEI �] <br /> DESCRIPTION OF WORK �l� A� ��g Z(� N�,�„�� ` S (`z� F� �r'-L� <br /> BUILDING SIZE SQ FOOTAGE C] HEIGHT <br /> QBUILDING a <br /> s 40:�.�rJ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY �] W.R.E.C. <br /> OPLUMBING a � <br /> C� �� � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � 7 `� <br /> ,� ,S � <br /> U� � _ -� I <br /> OGAS Q ROOFING Q SPECIALTY � OTHER �,,� P <br /> FINISHED FLOOR ELEVATIONS I '�f � � <br /> FLOOD ZONE AREA QYES NO v <br /> BUtLDER k , � COMPANY �ow ����,�(-�I`"�'�K�'*���t���, <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 8:�� 7.,u, � . � �,. ��63)-��� �� � �06�Q Z� <br /> Ucense# <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE _ RECISrEREO 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 /> IIAECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# � <br /> OTHER COMPANY <br /> SIGMATURE 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 Permit for new construction, <br /> Mfnimum ten(10)worlcing days after submittal date. Requfred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facili8es 8 1 dumpster;Site Work Permit for subdivisionsflarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W PeRnit for new construction. <br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for ali new projects.All commercial requirements must meet compliance <br /> 31GN PERMIT Attach(2)sets of Englneered Plans. <br /> �w�wPROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Filt out application completely. <br /> Owner&Contractor sign back of applicaHon,notarized <br /> If over 52500,a Notice of Commencement la requtred. (A/C 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 COUNTER PERMITTING (Front of ApplicaUon 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 />