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<br /> � a��-rso-0o2o City of-Zepliyrhills Per '�plicatiorr �� •002� � �
<br /> � �� Buil�ng D ent � �
<br /> Data Recelved � phone Contact for P �rt ilting ', 479. 644 _ 0183_�-•'''��
<br /> -e-r-rr����-s-�� . m-r,-.-.-,-r-.33T1� 7"'Y~rT-r �.-r_,-�-,-,-.-r
<br /> Owner's,Name �-E��V@�t,.ICIC. �_,.� mbgv-"$50r450-7492 -.,
<br /> ar Phnn t�Lr
<br /> ownec's adt�ress 320Q!-IaCkb2�'ty Rd. ow�er Phone Numtrai ( ,]
<br /> Fee 5imple Titleholder Name � � Owner Phone Number �� �_
<br /> j? Fee Simple Titleholder Address
<br /> JQSAp�RES3 - �� �OT# E3 tgc 9 c.:� ..
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<br /> SUBDIVISIDN ��PHYR�COMMON� P����i�35-25-21-U130-40000-0080/35-25-21-0130-00 �00,-0090
<br /> �, {497AtftEO FROM FROPER'fY TA7C KOTIGE} '
<br /> ' WORK PROPQSED � NEW CONSTR 8 ADDlAIT � SIGN O Q DEMOLISH
<br /> � INSTALL REPAtR
<br /> �` PROPOSEO USE Q 3FR � G4MM � ClTHER
<br /> TYPE OF CON$TRUCTIpN � BLOCK Q FRAME � STEEL Q
<br /> oescs��no»aFwo�sc New Gonvemence store building t+zj ', �, •�,�., ��" t
<br /> BUILDINGSIZE SQFOOTAGE3,��� HEIGHT ���'0��
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<br /> i� �BUILOING �'rjOO,OOO.00' VAlUAT10N,QF TOTAL CONS7RUCTION J
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<br /> i �EEECTRtCAL 5 �O,OOO.00 � AMP BERVICE Q PRO�f?ESS ENERGY Q W.ft.E.C.
<br /> h 600A, 12p1208V, � i+'�c��f''7=;: '
<br /> � �PwMeuac �25,OOO.flO 3phase � i.
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<br /> �MECHANICAL $ VALUATION OF MECHANICAI.INSTALIATION „�il' � ��r
<br /> , �� 5o,oao:oo � I ��� ,
<br /> , QGAS � ROOFING 'Q SPECIA�TY � OTHER r�,, '�. .7 -����
<br /> I 2 FINISHED FLOqR ELEVATIONS FLOOQ ZONE AREA QYES NO �,,� p
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<br />� � SUiLDER - CCtMPANY .. ^ , n�
<br /> � SiGNANRE ReasTazea ` N F�ecutu�Ecx YIN t�
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<br /> �'�-"l�� nadre5 ► � .ar�,.1�F��e9e# , G .'r.�){o�Gt ��
<br /> �I +`� � ELECTRICIAN �J (' J CpMPANY L?�'p`�
<br /> ���yp SIGNATURE �'^`e' ��\yY�� rtEGiSTErtEn Y/ N Fee araREn Y/N .J` ,,(�
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<br /> �,[,�- Address ticense# ��
<br /> i ��2" � �z.ur�eeu ��,� � �{`" ca�w Paan ����[�z j
<br /> St�,,kATURE i REtxMSTERED YI N FEECtlRRE�: Y/N -' '�; t��y
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<br /> �4� ;i Address L3censa# �,�y.
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<br /> ' MECHAMCAL �p(� _ ��:��y�Q��p„p//�,� ttEcrsP� Y! N' FEECURR�: Y7N ,�1•� �
<br /> �� SIGNATURE ��� "^•"'V
<br /> ,....,,. ...,,, ,._ = �;�� da.cic_
<br /> ���� Z dr�ess Cicense tk '
<br /> �� ��J �O OZHER ���� COMPANY ,��,
<br /> L..i t ��� SIGNATURE r�GISTEREo Y I FI FfE cuRRE� Y I N
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<br /> �y��� Address l3cense# � �
<br /> j��j(j�,� i Ii�I:I_iEll ! ltltl.11tl.C''/.ilt111 ! ! t { I.Iiltsit / tllti � llilSilllttlltt
<br /> %J""" , RESIpENT1A1„ Attach(2)Plot Plans;(2)seLs of.Buiid,ng Ptans:(1)sel at Energy Fams;R-0-W Permit fornew consWction, '
<br /> Minimum ten(10)working days aRer submittat date. Requ'ved onsite,Construclion FMans,Stwmwater Pians w+Silt�ence installed, i
<br /> Sanitaty,�acif$ies&t cfumpster;Site Wak Petmit f�subdvisions/iarge projects
<br /> COMMERClAL Aftach'{2}'comptc�te sets ot Bulding,P.tans ptus a Uie Safety Page;{i}set Ot Energy Forms.R-0-W Fermit far new consVuctipn. .,,3
<br /> A�inimum.ten(10)working days after sutimittal date. Required onsile,Construction Plens,Stormwater Plans w!Sif►Fence inst2lled;� ,.''
<br /> Sanitar"y FadlRies 8 1 dump'ster,SNe Worfc Pettnit for all new.prqects.Ail canmeraai requirements musfTneet compiiance
<br /> S1GN PERM(T Attach{2}seis 4t E�gineered Plans. �
<br /> ""PROPERTY SURVEY requireii for ait MEW consWCtion. •
<br /> • iC3 { i.:.,6it4ilL6G.: CiLiC.i • • pi�d'iLi: • •.6.d..T •
<br /> Directions:• -
<br /> F31t out dpptication Oompiefe�y.
<br /> Owner&GorStractw sign back of application,notarized _,
<br /> It over$2500,a Nqtiee.of Canmencement.is,reqWred. (AIC upgrades over$7500)
<br /> " Agent{tor ihe contracta)w Power of Attomey{tor Ehe owxrer}w4uid be saneone wiih notarized tetter fram awner authorizing same ?;
<br /> OVER THE COUNTER PERMITTING (copy ot conVact required}
<br /> � Reroofs if shingies Sewers Service Upgrades A!C Fences(PIoUSurveylFootage) ,
<br /> DrJveways•Noi over Covnter iY on pnbtia roat�vays..needs RqW
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