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813-780-UUZU c;ity or �epnyrnnis rermit Hppucaiion rdx-o�o-�ou-vu�� <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin - <br /> .l <br /> Owner's Name �/� �/'- r�c Owner Phone Number <br /> Owner's Address �� �� �OV'� S'��� �/f7�� Owner Phone Numbe� <br /> Fee Simple Titleholder Name ���� �'�—� Owner Phone Number � <br /> Fee Simple TitleholderAddress <br /> JOB ADDRESS o 6 .� SoL .S`���-� ,.,- ��r i� �� LOT # � <br /> SUBDIVISION � , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT [� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK S ���C'� � "���'� 1�,�- %� �CU� � �- I� . <br /> BUILDING SIZE / � SQ FOOTAGE /��� HEIGHT <br /> QBUILDING $ � VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ 9 1'J AMP SERVICE �� � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � � _ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ' I �� � <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # °� ���j s'�� a� <br /> ELECTRICIAN "" COMPANY �/ C� C� �ZG°'�1711C Ll L <br /> SIGNATURE REGISTERED N FEE CURRE� Y/ N <br /> Address � �� � � License # �� � �G �� �'� 9 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # r <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �— —� <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new consUuction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construcdon Plans, Stormwater Plans w/ Sflt Fence installed, <br /> __ Sanitary Faciltties & 1 dumpster; Site Work Permit for subdivisions/large projects <br />