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<br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />I I <br />813-780-0020 <br /> <br />Fee Simple Titleholder Name <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleho~der Address <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />LOT ## <br /> <br /> <br />PROPOSED USE <br />TYPE OF CONSTR~C110N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />33qz1"6C- <br />() 3-c:<6- :<!-Otf()j- tJli(j(J-oo;l{) <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />I ! <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />ui <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />YI N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />DriVeWaYS-Not over Counter if on public roadways..needs ROW <br />I <br />I <br />