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UILY vI ccNuynuus reams nNNut:auun <br /> Building Department <br /> Date Received ; 9^ Ph..Contact for Permittin4" 770 622 9858 �'0 f_5 <br /> 1-T=t- J'S LTL1..l-L1-J=11=(-1=1.L"YT"[t-TTi-'7-[-T'TT>-T - - .SSI=1._Li <br /> owners Name i Heartland Dental-Richard Jones_ _ bwccr Phone Number ��'d=�dU=�'16 ' DC/9� <br /> ;4200 Network Centre Dr.Effingham,IL 6240 Owner � <br /> Owners Address _- g —. Phone Number <br /> Foe Simple Titleholder Name j LCG2R 7344 Gall,LLC — ! Owner Phone Number !_727-786_2600 <br /> Fee Simple Titleholder Address <br /> 3500 Maple Ave.,Suite 1600,Dallas;TX 75219 — — —— — <br /> -- , <br /> JOB ADDRESS 17344 Gall Boulevard— — _--_ _ —--_— — LOT s —J <br /> � <br /> SUBDIVISION I, -.__.. . � PARCEL ID#; 35-25-21-0010-08800-0010_ _ i <br /> __.—. --_, •— .— (OBTAINED FRO[l PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADDIALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR x I COMAI Cr�� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK = FRAMEL=J STEEL _J <br /> DESCRIPTION OF WORK (interior remodel from bank to dental office. Exterior canopy removal. —_ I <br /> '4,390 S Ft �4390---� F14'-0" ---�� <br /> BUILDING SIZE I <l SO FOOTAGE i—__^_ HEIGHT I <br /> QBUILDING $550,000 _ j VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL i$ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> F-TIPLUMBING U <br /> QMECHANICAL — VALUATION OF MECHANICAL INSTALLATION <br /> L__ —. __—.-i <br /> =GAS F_X� ROOFING 0 SPECIALTY = OTHER n Iv <br /> FINISHED FLOOR ELEVATIONS I FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY _144erl�¢ T� t 1- t/Qi <br /> SIGNATURE t I,; t lJ ll i REGISTERED 'Y I N FEE CURREP Y I N <br /> Address �7_G✓$1J �yF�t y cz�, --—p — License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE 1 YYr ri.'t <br /> �r >��- REGISTERED [_ YIN _ FEE CURREF ! Y/N 1V"`�1 6--E' <br /> Address vom tA4"/.w1 tvej- _ 1 5' Fe License# <br /> PLUMBER �AM.PANY <br /> SIGNATURE s +/REGISTERED I—Y/N I FFEECURREn� Y I N <br /> Address ' OZ s. SGv frr,4 ,-A /""-.---.-_i License# (G F«yM 1-1Y3 <br /> MECHANICAL COMPANY <br /> SIGNATURE I 7 �;_r-�- _J REGISTER CUR <br /> REGISTERED Y/ N_) FEE REN —j Y/N <br /> Address 1q?7 af' f6k, G — ) Uceme# IG 44 D S6.0 76 , <br /> COMPANY { :5rlf4 /,CSC /LJ - H <br /> 4�st..•,,- i _ REGISTERED Y/ N_J FEE WRRa [_YIN <br /> 5 t Y "'Address L--_ _—r —� license is <br /> Id ! [ Qlttlllllltltllltlttllillitlilllteillllt1111 / 111161111111i1t811 ' <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortes;R-O-W Permit for new construction, <br /> Minimum ton(10)working days after submittal date. Required onsile.Construction Plans,Stormwater Plans wl Sill Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsnarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new ConstruWon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stomnrater Plans w/Sift Fence instaned, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> -PROPERTY SURVEY required for all NEW construction. <br /> t-a..a L.s . . toe_[.-• i1.e . . . . <br /> Directions. <br /> Fill out application completely. <br /> Owner&Contractor sign track of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from miler authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades AIC Fences(PioUSurvey/Footage) <br /> Driveways-Nat over Counter if on public roadways..needs ROW <br />