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�,�-�ou-uuzu c;ity ot Lephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin � � __ �U �Z�-- <br /> Owne�'s Name / t 14 -�C.h Owner Phone Number -�• � (� <br /> Owner's Address `1(� 1��`�.�i Owner Phone Number <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> Fee Simple Titteholder Addresa <br /> JOB ADDRESS �IC�, ,�� � _ � <br /> LOT#� �� �� <br /> SUBDIVISION � � PARCEL ID# ��j � .c�11 • I � 'bCk��j • C� 1 � ' <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1NORK PROPOSED NEw CONSTR ADD/ALT SIGN � Q DEMOLISH <br /> INSTALL 8 REPAIR � ��; <br /> PROPOSED USE � SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION ��" BLOCK Q FRAME Q STEEI Q <br /> DESCRIPTION OF WORK � C� �Q L}p �'S �f�Y� �i _��� <br /> BUILDING SIZE SQ FOOTAGE C� HEIGHT <br /> �BUILDING <br /> � �(�, -- VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> -� ���l� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION „ <br /> ��3�a <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# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGiSTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y!N <br /> Address License# —� <br /> OTHER � COMPANY �)C�u�l, <br /> SIGPIATURE � REGISTERED Y/ N FEE CU 1. Y/N <br /> Addross �{�,� v1� 5� Z � �J�JSy � License# �. J�-�� <br /> RESIDENTIAL AtNach(2)Plot Pla�s;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construction, <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Ptans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FadNtles 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pem►it for new construction. <br /> Minimum ten(10)working days after submittai date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new projects.All commercia!requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Pians. <br /> "•"'PROPERTY SURVEY required for all NEW constructlon. <br /> Directiona: <br /> Fill out applicatlon comp�etely. <br /> Owner&Contractor sign back of applicatlon,notarized <br /> If over i2500,a Notice 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 Application Only) <br /> Reroofs if shingles Sewers Service Upgrades AJC Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br />