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""-""'�"""' c;ity ot Lephyrhilis Permit Application <br /> Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> �� Phone Contact for Permittin <br /> Owner's Name d5 �f� f� Owner Phone Number c7�,3 �g� -'8S <br /> O�nrner's Address � Jl �L�E.� l I�L' �� <br /> Owner Phone Number <br /> Fee Simple Titleholder Name <br /> Owner Phone Number <br /> Fee Simple Titleholder Address <br /> r �� <br /> JOB ADDRESS J i U� ��'`�� <br /> LOT# <br /> SUBDIVISION PARCEL ID� l:7 ��j QI �() CY,�j� C.�� <br /> (OBTAINED F�RO�—M pROPERTY T�TiCE)DEMOLISH <br /> NVORK PROPOSED B NEW CONSTR� ADD/ALT [—� SIGN <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTIOId Q BLOCK Q FRAME �� STEEL Q <br /> ` <br /> DESCRIPTION OF WORK � f„yT �� <br /> BUILDING SIZE SQ FOOTAGEC] HEIGHT <br /> OBUILDING a <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL � AMP SERVICE <br /> Q PROGRESS ENERGY ��-'y W,R.E.C. <br /> QPLUMBING � J <br /> ��S(� 5 f, <br /> OMECHANICAL a ���� � VALUATION OF MECHANICAL INSTALLATION / f <br /> / <br /> OGAS Q ROOFING Q 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 <br /> License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# —� <br /> MECHANICAL � � COMPANY �/�ff/e�S �'�l fj/�� C-�c)y �I/Gs,,�'� <br /> SIGNATURE ��"��� � � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �� C'� �� � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w1 Silt Fence installed, <br /> Sanitary Fadlitles&1 dumpster;Site Work Permit for subdivisionsAarge projects <br /> COMMERCIAI Attach(3)complete sets of Buflding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minlmum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster.Site Work Permft for ail new projects.All commerc(al requirements must meet complfance <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> ""PROPERTY SURVEY requfred for all NEW constructlon. <br /> �.��.... . <br /> .a.�.aa 99�ii�r�r,��r�e�i��.�,�.. <br /> DlfeCt10�1S. � ��� <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of applicatlon,notarized <br /> If over i2500,a Notice of Commencement fa roquired. (AIC upgrades over=7500) <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 AppNcatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurveylFootage) <br /> Drivewaya-Not over Counter if on pubiic roadways..needs ROW <br />