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tS7J-/tlU-UU'LU c;iry ot Lephyrh Ils Permit Application Fax-813-780-0021 <br /> Buildi g Department <br /> � <br /> Date Receieed Phone Contact f r Permittin �� � � -- p2, <br /> Owner's Idame TlZ��.,� Owner Phone Mumber I '' ���'�, � <br /> Oxdner's Adclress �� �� L, Owner Phone(dumber <br /> Fee Simple Tttleholder Mame Oumer Phone Number <br /> Fee Simple Titleholder Address <br /> JOB A►DDRESS b'( I /�h /� �� % b� LOT# � <br /> SUBDMISIOb 1 G-� , �� � PARCEL ID# D3�b����76 �(��4L�"'���j� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WOR6(PROPOSED B N TALLSTR� REPAIR � SIGN Q Q DEMOLISH <br /> PFtOPOSED U5E Q SFR Q COMM Q OTHER <br /> 'TYPE OF COMSTRUCTIOM Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTIOIdOFNHORK �� il�sb� v�`'� /f���� Q(.�r <br /> �UILDI(dG SIZE SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION F TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVIC Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> �MECHAIVICAL $ B O VALUATION O MECHANICAL INSTALLATION ���" � <br /> � �o- .�� <br /> QGAS Q ROOFING Q SPECIAL Q OTHER <br /> FIfVISHED FLOOR ELEVATIONS FLOOD Z NE AREA QYES NO <br /> BUILDER COM ANY <br /> SIGRIATURE REGIS ERED Y/ N FEE CURRE� Y/M <br /> Address License# <br /> ELECTRICIAfd COM AfdY <br /> SIGMe4TURE REGIS ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUIMBER COM AIdY <br /> �IGfdATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address Ltcense�# <br /> M�CHAfdICAL conn nr�nr D�� S�S�ou,v� �T/��JC� <br /> SiGIdATURE � REGIS RED Y/ N FEE CURRE� N <br /> Address �C��� �- ,3(� � �Z r`� �� � License# //<L/4� /�!o� <br /> OTHER COfM NY <br /> SIGMATURE REGIS RED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set af nergy FoRns;R-O-W Permit for new construction, - ` - <br /> Minimum ten(10)working days aRer submittal date. Requ red onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FacillUes�1 dumpster,Stte Work Permit for sub visions/large proJects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safe Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Requ red onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 81 dumpster.Site Work Permit for ali n w projects.All commercial requirements must meet compliance <br /> SIGfd PERMIT Attach(2)sets of Engineered Plans. <br />� ""'PROPERTY SUR1/EY required for all NEW constructio . <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over a2500,a tdotice of Commencement is requlred. (AIC upgrade over E7500) <br /> •• Agent(for the conVactor)or Power of Attomey(for the owner)would be s meone with notarized letter from owner authorizing same <br /> ONER THE COUNTER PERMITTING (Front of Appllcation.Only) <br />, Reroofs if shingles Sewers Service Upgrades A/C Fences(PI USurvey/Footage) <br /> Drivevvays-Not over Counter if on pubiic roadways..needs ROW <br />