Owner:         

Address:       

City:          

State:             ZIP Code:       

Contractor :

Address:     

City:          

State:              ZIP Code:

Phone:       

Email:    

Legal Description:       

Lot No.:                  Subdivision: 

Block No.:                     Zoning: 

Job Address:    *Note: Do not guess at address, if you are not sure contact                for assistance.

Class of Work:    Residential            Commercial

Architect:            Phone:  

Engineer:             Phone:   

Electrician:           Phone:   

Plumber:              Phone:  

HVAC:                 Phone:  

Square Footage of Building:      

Size of Lot:  

Value of Work:     

Water Tap Size:    3/4" 1" 2" Larger than 2"     *Click here to look at the tap fees.

Sewer Tap Size:    4" 6" Larger than 6"

TDLR Review submitted? Yes No    If yes, EABPRJ no.

Describe Work: