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�--- -— <br /> 813-'780-0020 City of 2ephyrhilis Penmit Application Fax�13.780-0021. <br /> Bu+�Stng Depadsnent _ <br /> . <br /> Date Recelved �Q" +�� � T� Phone Contact for Pemiittin �/� s�'� (��R v <br /> � 1I � ilt } rrr�-rrrr'�r t � a � : lii�f `�� ' <br /> Owners Nama �—'`�'�''r' � R^�-`^�%k'.X S ca,n Qwner Phorte Number F�'/3 -3GJ S~�(Q l O'L <br /> ownee's Address �2�.).�. �..cw^�'.e.l u.��a� i,`��• Owner Phone Number � � , <br /> Fee$tmpie Titlehoider Name �� � Clwner Phone Num6er �, � <br /> Fee Slmple Titleholder Address ��� �v 11-�l.�F.�d �.�.�'. � 1� C l,t.�.�,�5 �^ 3�'S�{�. <br /> ,�os nnor�ss I.�..,,.-r,.�� +w.v8� t`�{. , r��r+� ��� ^ <br /> l�'-{ 3�,._ , <br /> susoms�oN � � Paeces.aat . �3.'�lo•�l-C?! o-JoaOcr-- D.�E�� <br /> � , {o97AWEDFROMPRopERTYTNtlioslCEf <br /> WORK PROPOSED � NEW CONSTR 8 ADD/ALT Q SIGN Q Q OEMOL�SH <br /> IN97ALL REPAIR <br /> a�opas�o us� Q sr�e Q caMn� � arH�+� <br /> TYPE pF CONS7RUC71qN Q BIqCK Q, FRAME C� STEEL Q <br /> DESCWPTiBN'OF FNORK � t' L 4�t? a �' �-D v. S��R '�'S ' <br /> SUitDINCi S�E �� &Q POOTAGE�� HElt?tiT ��_�_� <br /> QBUILDING �� VALUA710N pFTOTA6 CONSTRUCTION. <br /> QELECTRICA� r$ � AMP SERVICE Q PRqGRE$S ENERGY � W.RE.C. <br /> 1 <br /> QPLUMHtN6 �� ������� � <br /> �MECHAN�CAI. $����f 3� VAl.UA'T10N qF MECHAh11CAL INSTALLATlON <br /> -�-- <br /> Q�AS Q ROOFING [,] SPECIAL:'1'1' C] OTHER <br /> �SNf^aHED FLOOR ELEVATtON6 �—� �{.aQD ZQNE Al2EA QYE3 NO � <br /> I � <br /> eu�uA�tz � � can�adt�Y <br /> SIGNATURE I t�cistEREn � FEEcuRREh �YfN � <br /> lidd�asa tScense#7 1' � <br /> �L��TRG�4AI � ��.'�Fl�!`:Y � <br /> S3GNATURE I `� t3EcastEt�o Y t N �cur�t, Y!N <br /> Address Licen&e# � � <br /> ' PlUMBER � � C�3MPARtY j � � <br /> SIGNATURE �t9rer+� Y!N ��cuwz�n YfN <br /> Addregs ( _ _� ficense#�� <br /> MECHANICAL � COMPANY Vdl: V..FI Scv� Ai<"` � ����^� <br /> " SIONATtlRE �GiSTEttEo Y f N FEe Cu� Y.t N <br /> pddress S��{(�+'o • �{•-s Q4.aJ�#�L l�O�.�t.7��' Ucensa#�4r�C� E7J�'�'1'� 'L � <br /> 333� <br /> OTHER � � CBAAPAHY <br /> SIONATURE Recr57Eaen Y!N FEEcuaaEn Y/N <br /> ,y���� License#((����� <br /> ILIIIIAIIIt11`IIIIG1fIfI111f111111111I1111I11111111111Ttlllili11111t <br /> RE31pHNT1A4 Attadr�2)Piot Plpns;(2)sc�ts of Bullding Plans;(1)sat of Energy Forms;R-O-W Pertnit for new cqnstruction, <br /> Minfmum ten(1U}'wort6ng deys stier euhmittei date.Reguired onsife..Construstiao Plans,Stdcmwater Fians wl Stlt Fsnca instaEted,. 4 <br /> Sanitary Fac3fiF{es&1 iiumpster,Si#e WorSc Pettnit f�subdivisionsltarge pmjeds <br /> COMMERClAL Attach(2}compiato sets of Building Pians plus a Life Sefety PaAe;(7)set oi Energy Fortris,R-aW Permit fo�new eanstrucUort. � <br /> , Minimum ten('!0)uroridng days after su6mittal daie. Requimd onaNe,Consin�ctlon Plans,Stonnwater Plans w/Silt Fenoe installed, <br /> Sanitary Eae3Giies 6 1 dssmpster.6ite Work Peemit_fo�a1(new projacis.A{I cammeraal requlrements must meet camp�'�anca , <br /> SIGN PERAAR Attach(2}sets ot Engiri�red Plans. <br /> ,•»pRG�PERTY SUR!�EY reGu?r�+f�r el!I�E!k sor.sln.wtia�t. • <br /> QiraaUons: � <br /> Ftll out appiication cainptetety. �' <br /> CMmec 8 Cantractor sign BarJt at applicatiqn,noterizsd <br /> � 1t aver f25d0,a Noticu ot Commeneemem ts roqulred. (A!C upgrades over 5T5QOj <br /> :k' <br /> " Agent(for!he c.�atradar}.a Power af Attwney{ior tha gvmerj wautd tie somaorte with rtotsriied Iatter#rom mmer authwizing same <br /> OVER THE COUNTER PERMRTING (aopy of conkrect required)" <br /> Reroots+�shfngles Sevrers Sendce Upgsades NC Fenoes{PlaUSurvaylFootagej <br /> Drfveways-Not arer Cnunter if nn pubtic roadways..neade Ft0{N <br /> �a <br /> �_..,_...___.__._______._�__..._.._,._�____._.Y___, �_�...._...______:_....__�._..._�_ , __..._.._._.__.,..�,_�___.__..___._.,�_______�r .«__.._.�.r____..._._____.„, ' <br />