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o io-rav-uu�u c;iry ot Lephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date'Received QS l�j ,, l� _. O a.1.6 <br /> Phone Contact for Permittin <br /> Owner's Name OAk- Q.��^ �('o e � T< < S � V�.C• Owner Phone Number <br /> Owner's Address 3�d�O D�v.►t�HT 2�Y.�.,2'�'F��b5� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Addresa <br /> J08 ADDRESS 311�3 Oi4K.. Q�L�N G�Q.� ZCPH 6Nl�.LS F G LOT* � <br /> SUBDIVISION � PARCEL IDA� 34 'o�J - a,L' C��«� - �`�C�30Q ^��Od <br /> (08TAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED B NEW CONSTR 8 ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �'Q °�"� Cv Nt e S�C,C 5 � �C��++�.`�. ��oor c�- , �.00 t� � 2,��- - <br /> BUILDIN(i SIZE SQ FOOTAGE ��� HEI(iHT o ' <br /> QBUILDING S VALUATION OF TOTAL CONSTRUCTION l� ��� <br /> QELECTRICAL s AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING s � <br /> _�j �`1� <br /> QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER - � ,? '�'� ` � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <br /> BUILDER \ COMPANY �''1 LJ3`�'�'�`��" ���-C.-� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 3 �\3 �'Q._ P ^'t'1.�� License# ��L �T'J� 1�� ( <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas Ucense# r <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addross License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set oi Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)woticing days after submfttal date. Required onsfte,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlitles d�1 dumpster;Site Work Permit for subdivisfons/large proJects <br /> COMMERCIAL Attach(3)complete sets of Bullding Plans plus a Life Safety Page;(1)set o(Energy Forms.R-O-W Permit for new construcUon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary FaciNHes 8 1 dumpster.Site Woric Permit for all new pro)ects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> •""PROPERTY SURVEY requlred for all NEW constructlon. <br /> DirecHons: <br /> Fill out application completely. <br /> Owner 8 Co�tractor sign back of applicatlon,nota�ized <br /> If over 52500,a Notice of Commencement Is requirod. (AfC upgrades over 57500) <br /> •' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter trom owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of ApplicaUon Only) <br /> Reroois ii shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..needs ROW <br />