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813-7ea-0020 City of Ze ftMlls Permit Application Fa*a13-78"D21 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permifllrlg ( ) - <br /> i a ■ a 1 a a a ■ a r i a 1 . , , , , 9 , L11 <br /> a a a a 6 1 4 0 <br /> Ownee3 Name KL!^�� �o Owner Phone Number iD ff3 7 '1 Q N <br /> Owner's Address -?1eZA' Whje. e Z Owner Phone Number —� <br /> Fee Simple Titleholder Name Z Owner Phone Number <br /> Fee Simple Titleholder Address )-72 r y 1t,)AW., 1 0 'E; 2eTjnjrWt1 - FfOl- A 333r Z. <br /> JOB ADDRESS T %A.) ptv•er LOT <br /> SUBDIVISION PARCEL 10# <br /> (OBTAINED FROL PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW ZNSIR ADDIALT = SIGN DEMOLISH <br /> INSTALL B REPAIR <br /> PROPOSED USE SFR = COMM OTI4ER <br /> TYPE OF CONSTRUCTION `= BLOCK FRAME STEEL �] <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE .7�.! SOFOOTAGE®2(00 HEIGHT I for 1t-L 3O <br /> CCa:EC€JLXXX EX€C€€C€€€XEXL4EEEICiXt XXXEiiCLCCCC€€€CLC€€€CCE€€€xXECXXt <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C. <br /> =PLUMBfNG is i ll&,5' <br /> MECHANICAL $ VALUATION OF MEC <br /> HANICAL CHANICAL INSTALLATION <br /> A-800o <br /> =GAS ROOFING ® SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANYSIGNATURE L REGISTEREO YIN FEECURREN Y f N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED YIN FEECURREN Y f N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y f N FEECURREN Y f N <br /> Address Ucwse# F— <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y f N FEE cuRRew Y/N <br /> Address License# <br /> OTHER /J/r Q COMPANY <br /> SIGNATURE REGISTERED Y f Nj FEE cuRREN Y/N <br /> Address 51 IZ 'tK License# <br /> 1111ll11tl ! ! lflltltftEEt1111i tE ! ! ! !•I ! ! ! 11 i [ lIII ! E1.� ll � ! lIIIlIIIIt1111lI1tl11tf <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of$wilding Plans;(1)set of Energy Forces;R 04V Permit for new construction, <br /> Z d dL9:W OZ t O 0e0 <br />