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From Hawkins Eleiric 1.813.322.8345 Fri Dec 7 09:26:00 2018 MST Page 1 of 1 <br /> v IIra�,W&v 1ri[y oT cepnymws I-ertnli Application Fa*813-740a21 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> Owner's Nams ( /��C3�CTY� O �-1 Owner Phone Number <br /> Owners Address owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Poe Simple Titleholder Address f <br /> JOB ADDRESS 6—w( Sj WE� p4) i1 bj- LOT# <br /> SUBDIVISION PARCELID# 05%X s2l f 07b G030D (5630 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CON ADDIALT SIGN Q DEMOLISH <br /> ® INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM © OTHER I I^M-Llt .'ialiNZRO <br /> TYPE OF CONSTRUCTION Q 8 iLOCK Q FRAME u STEEL Q <br /> DESCRIPTION OF WORK { a ! {a+ / f <br /> BUILDING SLM SQ FOOTAGE= HEIGHT <br /> ILDINCi $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY © W.(i.E.C. <br /> =PLUMBING <br /> Q a� <br /> MECHAhiICAL S VALUATION OF MECHANICAL INSTALWTi <br /> []GAS ROOFING © SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ j V. FEE cuR6 Y J N <br /> Address I Kir "r , �( 7e O r License# <br /> ELECTRICIAN <br /> SIGNATURE <br /> REGISTERED 1 7,/ NPEE CURREr. LILN <br /> Address �e <br /> PLUMBER`'� V COMPANY <br /> SIGNATURE t REGISTERED __yt7 Nej FEE CURRE11 Y/N <br /> Address di Mf�e License# COIC ' <br /> ------------ <br /> MEClfICAI. COMPANY <br /> Si8 REGISTERED Y/ N FEE OUR RFJ.C( jL• •�N� <br /> ��, .''� - iS ow 36" C License# <br /> OTHER 7 <br /> COMPANY r <br /> SIGNATURE REGISTERED I YIN FE&CURREA Y! <br /> Add noss License# <br /> RESIDENTIAL Attach(2)Plot Plans:(2)sets of Building Plans;(1)set of Energy Forms;R-O"W Permit for new construction, <br />