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- - �-- ---� ���y u� �epnymnis rermit Hppncauon Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin - <br /> Owner's Name C.,��'�- �G R�'� Owner Phone Number 7�,3' � l� <br /> Owner's Address .S�� �J C '�� ,Sl �€' /� �1�> Owner Phone Number �— <br /> Fee Simpie Titleholder Name �— Ovmer Phone Number � <br /> Fee Simple Titleholder Address <br /> JOBADDRESS •��G� %'''� Sl Z�f/���h'�t � �'_'`� LOT# C� <br /> SUBDIVISION �— PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN [� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER �/�c c���'' <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK cu��° ���`'� ��� S/� SP�c�S 5��� .�'`�� <br /> BUILDING SIZE � SQ FOOTAGE C� HEIGHT <br /> OBUILDING � VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E C <br /> QPLUMBING $ <br /> OMECHANICAL $ ���n��j� VALUATION OF MECHANICAL INSTALLATION <br /> �GAS 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# �— <br /> ELECTRICIAN �.� COMPANY <br /> SIGNATURE ��� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �- � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL ���-• ,,�/Y"� COMPANY ����'10� /1�£et!l�-��,t,�L�d� <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 7����✓��1�i"/L'IQ��" ��G��t���� (�r License# �G �Z Y � ` v` I <br /> OTHER � � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN 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 construction, <br /> ..._•__..-- `--..... ._�.�--�'— -°---..�_�u_� .._._ �__..a--�--_:�_ i._�_a.....u_�n��..� os.._...�a��n�...,....d c:u o.......,s....�..n...� <br />