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913-780-0020 City of��phyrhill� Permifi Applic��ion Fax-813-780-0021 <br /> B�ilding,De�ar3xnent <br /> �aie{��c�iv�ai phonm Cont�ct for Permittin ( 13 � a -- � <br /> "`H�`H ll-8- a <br /> _A.�r�er's�e ��r�n�e Phod9e-Ni!r���� -� S <br /> �wnor's Addr�s � (�SO�ursor Phono ftfumb�r <br /> ;s��a:`�'��8a 3iai��a�3r7o��;arria ' ��ari��-P����iJu�s��;° � <br /> Fe�Sirnplc Titlehotcfor Add�s� <br /> i .b���P��"� � �.S L�i� � <br /> Sll�DIlfISBON � I-t J-�����}� �)t 1�q. �PA�C�L Ip�_.__�.__ --,_.- l Q l Q� (�OC7C) C9 ' 21. ' <br /> i (t9F}FAlNED:FR0�9:PRAP�ftF1'TA?GNt3Y�ICE�; <br /> W�E�t�Pi�OP�S�D � NEU1!CONSTR� ADD/AL7 � SIGfU � � DEMOLISH <br /> INS'f�LC F:ERAk� <br /> F6�SFPO��D US� � SFR � COMiVi` � OTNER <br /> .�r��o��v���ucri�� �. ' 's�ac�t [� �►araM� C] s�-��L � <br /> ���c��rir��v.o�v�n�r� u`1 � � rr , � ,r <br /> �v;3 3�ir�ii�a�L � '� ^J'V r�'c�L iF.'.^�rL-''' �V . ��i17i'i:7 �' � <br /> -e-tr-u-r-u-u-`rv-u- o--�--u-ir-rr�r-u-w=u-=e--"'o r-�t--_ n- a-- u'-r-'a tr'�a-"u-v o�i�=- a'-"�u "" �� i <br /> �BlllLDING ' � � VALUATIO�!OP TOTAL CONS7RUCT10N <br /> ���'� <br /> QELECTRl�f1L � �iVli�5E�1lIC� � PROG�'=SS�fVERGY � W.R.�.�. <br /> '�PLUM�IiVG � , . - <br /> Qflli�CHRNICAL � � VRLUATION OF MECHANICAL INSTALLATIO(V ' <br /> �(3A5 � ROOFING [� SPECfAL'I'Y' [� OTHER <br /> FtI�15H�D FLDDR ELEVATlDNS � FL:anD Zt7N�l?�P.E�l �YES NQ � <br /> n:,+�s_�A�..�..2 �� �R-.�,-�-- °.�-�...=�:�"�� <br /> ��f�.�r�e� - - 1 ��riv3E�di�Y' r�'�-� i��6��� <br /> ��������� �Q-P REGISTERED Y/ (V FEE CURREP �/(�j <br /> ��d«�� d � ` Is�s��. �;�8�s8� r�� i a s �'I <br /> �E�GYth9ClAfV .. �flN1�At�Y <br /> ���"��+���� " REGIS`CERED Y( R! ' FEE CURREt� Y.({U ` <br /> 1�d9�6'QS� �.1E2ii�� ���._� <br /> d�l�lbF��d�GC � C0�7PANY � � � <br /> �IGRIATU� REGISTERED ' Y/ Pl FEE CURREA Y/N <br /> - �ddrea�� Lit�ense�# �— <br /> MLCF7A�!!Cl�L �����y <br /> SIG111ATU�3E 1�GISTERED Y/ .(1� , �EE CURREP Y/(V <br /> t�dd� Licen��� i � . <br /> OTMEt? ��Mp,q�y <br /> ��G�'�T�R� REGISTERED Y/ fU FEE CURREfi Y/N <br /> A�de�gs - - - - Lfcense# . - ��v <br /> B 0 9 6 8@ � � S 6 i 9 � 9 � 9 9 9 fl 9 9 9 t i � 6 Ti B 9 E 9 E D � 0 0 '0 � b �"E"A � .�-�-� � 8 B E �.� l i � � 9 0 8 a 9 9 1 O 0 � A <br /> R�I��E�►4f�1. Attach{2�R1aY Plsns; E2}se�s of�ullding Pl2ns;(9)set of En�rgy For�n�;R-t3-W P�rmit for ne�nr cortst�ucfion, <br /> Pliin�ur ten(S4}v�r;;t;ing day.�ancr suSriiifi�C ciai�, �'�quira:i.or�sif�,.Ca�sfrucFinn Ptans,Stamwater PI6p5-W/Silt-rei7Ce inst�fleo,� <br /> Sanitary FaciliEies&1 c�umpster,Site V�JorR Permi4 fior subdlvislonsllarge praj�cts <br /> �t���i����d�l�� Attach(2)compiete sets o�Building�Plans plus a Life Saf�fy Page;(9)set of Energy Forms.R-O-W Permit for rtew construction. <br /> I�inimum ten(10)working days efter submittal da4e, R�qufr�d onsite,Construction Plans,Stormwater Plans wl Siit Fen�Instaited, <br /> Sanitary Facititias&1 dumps4er.Slte Work Permit for�atf new projects.At!commercial requirements must meot compliance ' <br />� �l��f P��t�9t� Attu�h(2)sets of Engineered P�ans. <br /> '="PROPERTY SURSlEY res�uicec{for all NEW construcCion. <br /> JL1L n n n_�n_n_ n n n n n n �_n� q rLn n n <br /> �If�8CtI0[15: <br /> �FilFout appiica4ion coinpteteiy. <br /> Oven�r a�en�racior s;gn.bac�c•ofi.appii�tio�,natar�zeu <br /> i?ow�e�2�00,a Notice o�Coanmancc�tnonY i�requ9red. (A!�u�g�ad�s ov�r Gu7�00) <br /> `� Agenf(for the contraotor)or Power of Attorney(for th�owner)would b��omeone with nofarized letter from owner authoriaing,sam� <br />' C1V�Pd i W�CDURlYE����Ml�"fl�fG (copy of contract required) <br /> f�eroaf�s if shingios S6w�r 58rvice Upga��s AIC F�na��(���tl�urv�yl��ota��) <br /> 4�vevc�oyo=t41o1 avov Cour�ftcP i#an pub4i�saz,dwaye..re�s4s�Q1}�i <br />