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�"-'�""""`u �:ity ot Lephyrhilis Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> Date Rece(ved <br /> Phone Contact for Permittin � ; �8 c�. __�� L <br /> Owvner's Name �'1p.��V WL Owner Phone Number S- <br /> Owner's Addresa �� � '� , Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS �Q�I 3�� �/'�c �U.-� , ��. LOT N �� <br /> SUBDIVISION PARCEL ID#� ' a� 02 I ' � � �S. �"�('�1• ��� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1MORK PROPOSED NEw CONSTR ADD/ALT SIG �� DEMOLISH <br /> INSTALL 8 REPAIR � � •�pU�T <br /> PROPOSED USE � SFR Q COMM �� OTHER r— <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME �� STEEL Q � <br /> DESCRIPTION OF WORK t A�P. t, �Q�� l}a }��S '-�'�� � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> �BUILDING S � VALUATION OF TOTAL CONSTRUCTION <br /> ' S• <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �_Q�j <br /> � � �.. <br /> QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION -� <br /> QGAS 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# C —� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGiSTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER COMPANY VVI�h'1 Y"/DUf��, . <br /> SIGNATURE REGISTERED Y/ N FEE CURR Y/N <br /> Addreas L -}'L ��S'-{� License# I C����3a�� <br /> a-- <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new consUuction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles 8 1 dumpster;Site Work Permit fo�subdivisionsAarge 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)working days aiter submittal date. Requi�ed onsite,Conshuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.S(te Work Permit for all new projects.Aii commercfal requirements must meet compBance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ••••PROPERTY SURVEY required for all NEW consVuctlon. <br /> Directions: <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of applicatlon,notarized <br /> If over 52500,a Notice of Commenr.ement is required. (A/C upgrades over 57500) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would be sameone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />