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Date Received Phone Contact fo Permitting j `7 ) 45-3 t' - 4 1 1 0 <br /> I1111111 ''11 11111_ <br /> Owner's Name e�W e. R)LARZI-- Owner Phone Number a 7''702-- 2.9-� <br /> Owner's Address YJ✓ �3 �T Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address .� 2 <br /> JOB ADDRESS �373g �� LOT# <br /> SUBDIVISION �•�i {T Fa � 1 PARCEL ID# Z 2-6 -11 -004D '005 0110 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR 8 ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL � �+ Q <br /> DESCRIPTION OF WORK W OOD"S mar-Rid..&Le FL 67KI.15' FL ) 7*b � 1 <br /> BUILDING SIZE SQ FOOTAGE= HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> d o <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N Y/N <br /> Address I License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N Y I N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N Ljj N <br /> Address i License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N Ly/N <br /> Address ] 1 L License# <br /> OTHER /` >�COMPANY 17D <2. Pr.,� t A'jj{,I Le, <br /> SIGNATURE REGISTERED Y/ N Y/N <br /> Address 1 $d 10 2,W>t to 71b License# o,(iL iso J vvj <br /> illllllllllllllllllllfllllilllitllllltllllllllllllltllllllllllitlll <br />