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813-780-0020 Gity ot Lephyrhllls Nermit Hpplication rax-rsis-itsu-uuzi <br /> Building Department <br /> Date Received Phone Contact for Permlttin ��� �f� _ ��� <br /> Owner's Name ��Je- // p�QcQJ/' Owner Phone Number ���C � ��� �`3`/ <br /> Owner's Address c3�bZ L� /�C�/ L(� Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address �l.Q,✓" <br /> JOB ADDRESS ��6�-ul C~ ` -� 2� <br /> LOT# <br /> SUBDIVISION ��[-/C'cJ��.` (J�-/�1 , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) c7�r'2�- Z{� , 3�` <br /> WORK PROPOSED NEW C�NSTR ADD/ALT [� SIGN Q Q DE OCISH 0����� <br /> � INSTALL 8 REPAIR /Z�v <br /> � <br /> PROPOSED USE Q SFR Q COMM � OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �(,P. /"YfQ/� 7� (�„�/1 Q/� GUGY�� C'�� <br /> BUILDING SIZE �3 x � SQ FOOTAGE �� HEIGHT <br /> [�]BUILDING $��� �a° VALUATION OF TOTAL CONSTRUCTION � ���� / <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ PA.SCp PERMITSERV <br /> �7� � <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �8f 3)788-53�,� <br /> FAX 1-866-g24_7gg� <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER . /,, ° ' � �� COMPANY � ..fy�j� , �C - <br /> SIGNATURE �`�-�- C� ' l REGISTERED Y/ N F'EE CURRE� Y/N <br /> Address �Q l �7� /�-� � License# <br /> ELECTRICIAM � �: COMPANY Q��� 7D�2 �1 /d��f(fr <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ��oZ(e C, L��� � J�/ � License# � <br /> PLUMBER � COMPANY � "� /��G//1 <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address �7ot+�� J�' S� 8 '�7 3 —� <br /> License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address Ucense# —� <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,Constructlon Plans,Stormwater Plans w/Silt Fence instalfed, <br /> Sanitary Facilitles 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 FoRns.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans.Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&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 requlred for all NEW construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Confractor sign back of application,notarized <br /> If over;2500,a Notice of Commencement is required. (A!C upgrades over s7500) <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 Applicatian Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />