|
813.780;0020 City of2ephyrhills:.Permit Application Faz413-78W2l
<br /> :.Pulidtng Deparltnent.
<br /> 'I�alt��fit®calved .. _ ., ` - :.,<'�::; •:
<br /> Phone,.ContadErfor',.Perrnttttn ' ::' ',= "rf, >t':.
<br /> ,OWne�r:ptioil�`Numbe�:
<br /> .q, :.�..J.. •V,e:•r �MM II LL
<br /> Own "i•'er's• d r A d ass
<br /> iNn•'r.
<br /> b I:�tJam t
<br /> _ :�� - 'Ou�liar�hbn®�Nfintiet"�J ..
<br /> -F
<br /> ,.,
<br /> `l csl.
<br /> ``'JO 1�'34 CD>rtE-
<br /> sS: :,: ..,::- "•,_ !may
<br /> V
<br /> l..!ION,. - .�PARC,EL10# `•
<br /> �..�.
<br /> .F.
<br /> -
<br /> �.b81'AINED�R uuPp`
<br /> +4
<br /> L :1 S.
<br /> �R�• -fit 4°:W•• .OPOSEb
<br /> C.ON3 ;1. ::ADYI/ALsT'. .:SrGN'- s EMOEi H`'r
<br /> PR P O OS �D.USEl
<br /> - -
<br /> E
<br /> TYPE•OFC�• .�. U O �BL'•OCK `F
<br /> ESCRIpTION°0K- bitlG' CL
<br /> UILDING.SIZE 'SQ<.FOOTAGE .Hld�oklT``� -_ - :��{j,�:.;_.• - -
<br /> ,,,S;t,nti'1'. ?i,fr`IJ'•n
<br /> _ y;...
<br /> :. ...
<br /> 'a
<br /> BUILDING''
<br /> ::VALUAtION;OE:xflTAI:CONSTt2UC'flt)N�'` .-.' :. ..
<br /> EL`ECTRICAL:,.. II _;ANfI?'SERVICE.. .
<br /> PL'UMBING.,'.
<br /> =MECHANICAL $: VALUATION OF MECHANItrA1°,INS'TALt ATION'
<br /> r.�
<br /> =GAS = ROOFING:., 1 _ ,,SPE IAITYS OTHER:.
<br /> F �- k.
<br /> INISHED 1=LOOR;ELEYATIONS "i' ;dFLO0p1XONE:AREA •` '-'.'i` YES NO,
<br /> .BUILDER COIH,PANVI:
<br /> SIGNATURE �,:.,;.LRIGIS) REpf `.F E;CU RErir%'f '';iY� }''
<br /> ELECTRIC . ` ,,:COMPANY;.-1
<br /> SIGNATU -atEGlsf Lt2 ;, EiC R en:;.
<br /> :r S,
<br /> PIUMBLR' COMt;JdNX'
<br /> Rdi�iSJE�tiEo`' Yr%.N:,` .<:,' EE t7RR- N��
<br /> 'SIGNATURE'
<br /> MECHANICAL=. ,. - -
<br /> - REd'I§t>=RID:�' :Y/..,N�'.`Y 't'FFEE!CURREK::�'• ,.Y./'iN
<br /> 4
<br /> -
<br /> F.
<br /> OTtIER,,,',.._ _ COA21;;.AN,.. 'a: ::,•r �•�: ,��.:. �'{��'��=� - -
<br /> SIGIJAI'l'1RE;.. :r� :;ROB ROD' - /k�'N;.. •<:,�;,FEE,CURREn.',..,, ,, _ -
<br /> Address-.. ,_ -License;#
<br /> 3 l: 1, 1, ".: •.:4."r _ . I.: ie. _h✓ I fir. avll q l•„n:4 .. •%1%.t' L•. -
<br /> �VM i ,:4 .,�ti
<br /> J.' /:fit.'••
<br /> ,..,�t } - 'a =t fN Re. e'=cow
<br /> EN'CI141' Attad ^,"' t' la s !�`Sets bf�iylJdt' "PJdt1 '(1 ;suet cf i�'tg orb §eft, ►/� fof l7u W.,,
<br /> .�. 'jrr�' 7 �/'f'�� ::�•fp 3 s'� )� n, y .e,..•.,.at r. ..J. erri'>F1' .n.
<br /> -t� ri, t ,.'� �+s'*-xt' Y q,a�3• 9, J.rr t' •'i y1Mr; ra+ , �A'•t, '''s' ' ti:�':.
<br /> xtulinlrlturn:te t-op orkingaiiays.aftei s 1i I ale: R$ ire lonslteV:W9-.-.WWgdfi-Plt S, oririi atefPfeit��:vG_$I�t Fe c9,frlsti i sfJ�::-::
<br /> Sanitary:FaLtillties:$.dt nlpst r,Slf ;WoticlAeitliit'�fd,;Wilt3rs10n3n hEj rprgjeEts:':
<br /> COMMERCIAL 'Attach,2' rri'leteisats of,Bu idl ;Plans llts arli'�S'f` `P2ig'e (l=�seY°ofEnergy-dorms:R;O=W Perrmt;fo 0i*4ixl stnuctlon.;: >_
<br /> N1In(t>ti�m tam�1'/}�';wiirkln R'da''"a er' ttal `fie :;R- LA:nsite;Con llii,,,��6",��^.!'A"ice S'�ormW"at r" I Cii wl: Ilt,Fe Ce iil:#talled
<br /> .:,t,>a4ta w.: ti y„ PS I. Wt 'r.r.. .x�,s .....k�_ a7,- ....-. ,:;1 -. -ll�.�,:a.a_,...� ..,• _
<br /> Sartttary-t=aCtlldes:&;1tlu [�"r:•Sile.lYork`ISdrmltt�cr°a1l:riewproJectsAlt,commerdal:requ(retnents'_mutrieet°complf�ncc
<br /> SIGN PERMIT: At&ch'2„ee s;AfbEii"
<br /> (.,) yam:- ., �.[{},"•., .�,,•._:- .f,. .,t 'li. - - , .-
<br /> •••"PatSPR �$, 4veregiiea>foalrNi:WccfisriCEton:.
<br /> Dlreetlons: � ,
<br /> .Flll.out appllcatton•cwmpletely.
<br /> t Owndi'4 Cornrpctoc: ign,,: ack of apRticatign;.notanzed.
<br /> Ifdvers25d0;la�Notl�®`of'�:ommenpemenglsraqulredr�.(AIC upgrajdes:ovec-$y500)
<br /> iftF:',4,:�
<br /> ••" 'Agent(for:_fthe:contractot)�pr.Power::ofAttorney(f6rahe-owner)::yvouid`b.6. oHe.withiPotarixe'd;lettei_f M:bWedt..aUthdrtztrigsame: .
<br /> OVER'-.7"E::CO.NTER1PEI�M1171NG;.' (cop�r;�of cotitrp�relqut�ee)
<br /> Reroofsif.'shingles' Sewers Se'r'v—apjra`de§:iN'C`'::"F nCes'1PIodSUrvey/Footage) '
<br /> Driveways=Not over Counter if on.publ(c roadWays.,needs°ROW
<br />
|