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es�s-iau-uu�u C:iry ot Lephyrhiils Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin __ <br /> Owner's Name �l C� e/n/– Owne�Phone Number <br /> Oumer's Address �9a� �De�2 �� . Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Sfmple Titleholder Address <br /> JOB ADDRESS �/o�� ,6P � ,�e �'J /��, LOT� O�� <br /> SUBDIVISION �� ✓ PARCEL ID# o� a� -�l�- D«D° U�QG10 Da$� <br /> (OBTAINED F�PROPERTY T�ncE)DEMOLISH <br /> WORK PROPOSED B NEW CONSTR� ADD/ALT � SIGN <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK �f�°/V�/� �/� ��'jFj� , �–!f� CD7-y� �Je/�f� <br /> BUILDING SIZE SQ FOOTA(iE� HEIGHT <br /> OBUILDING E VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.0 <br /> QPLUMBING a �3���� <br /> �MECHANICAL $ , VALUATION OF MECHANICAL INSTALLATION � <br /> �`�/7.5', od <br /> QGAS 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 /> Address 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 CURREh Y/N <br /> Addreas License# <br /> MECHANICA c i��/l.L9-��1i�2� R OMPE NY "'�� / N FEE C RRE�J r�!/� <br /> SIGNATURE <br /> Address 'y'�/ /`t/l�h) ��, Z��ji� 5 �$��L� License# �%��n �}���� <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 Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Pians w/Silt Fence installed, <br /> Sanitary Fadlitles&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Build(ng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)worlcing days after submittal date. Requlred onsite,Constructfon Plans,Stormwater Plans w/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 Plans. ` <br /> "'"PROPERTY SURVEY requirecl iqr all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applicaHo�,notarized <br /> If over i2500,a Notice of Commencement is required. (A/C 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 Application Only) <br /> Reroofs if shingies ,Sewers , S�rvice Upgrades A/C Fences(PIoVSurveylFootage) <br /> Driveways-Not over Counter if on publ(c roadways..needs:ROW • <br />