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<br />09/13/2001 THU 11:20 FAX 4078628523 POOLE CONSTRUCTION
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<br />OlfN!:R' S N~ East Pasco Medical Center
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<br />PHONE 8.13-"j e8...24~1.
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<br />JOB ADDRJl:.n 7n?n r-~11 g""']'''''U'r1rrl. ?:"'ppyrpi).lF'l. Florida 33S41
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<br />L~~ DE5GRIPTICN: LOT(S)
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<br />BLOCK
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<br />straDIv.t 15 ION
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<br />PARCEl, :rn # Q-- :B.~+-..=:w,..""'_~ T.:ag-:::r.' ""-a........;r+-.;,.,.T1
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<br />(OR'I'JlfV lI"RCM "PRn'PRa't'V .,.~y Mn""Tr!1P.l
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<br />WORK E'RCl'SED: D~ CONSTRUCTION
<br />CloUGH
<br />I'ROt'OSED USE: OSGL FAKILY DWELL;UIG
<br />fJ COMKZRCI.a.L
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<br />D ADDITION
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<br />OMDVa
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<br />!iaAL':t'EllA.'1'ION
<br />D nI!:MOL:tSH
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<br />D REI!AIR
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<br />o ItlST~L
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<br />DMULTI-!'AKILY
<br />D INL'lI1STRIAL
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<br />[J 1# OF tlJUTS
<br />CJ SWIMKING POOL
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<br />CJ MOBILE HOM!:
<br />CJ O'l'9R
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<br />r::::::l qS'rAUAA.N'r & H!'ALTl{ 1)Bl'M'I'HZNT An~
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<br />DESCRIPTIOll OF WORK
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<br />~KVVVMVy.aa9V9MV~Z Patient Room ~~novation~
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<br />ZlU'ILDING SlZl!:
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<br />SQUARE .fOOTME
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<br />BEItm'l'
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<br />RESID1!:N':t'IAL:
<br />COHKlUlCXALl
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<br />ATTACH (2) 1'>LO'1' PLANS & (2) ,s!:'l'S CP BUILDING P1oM'1J , (i) SET ENI!:IlGY FoRMS.
<br />ATi'ACH (3) IJ!:TS OF BlJILnI~G PLANS .& (1) SET PfERGY FORKS.
<br />PIlOPER,"" SURVEY IU!:C1UIJ\EI;I FOR ALL NDf CON:!l'l'RUCTION.
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<br />PERM:rTS REQOES~
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<br />~ IlUTLDINC
<br />Xl );;:t.~RICAl.
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<br />$
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<br />VolUoUATION Ol!' TO'1'~ CONSTRUCTION
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<br />CI FLOIt:rDJ\. POWER
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<br />A!U SERVJ:CE
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<br />o W..a..I!:,C.
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<br />:il 'L~IN~
<br />iJ MECHJ\1II I CJl.L $
<br />o GM 0 ROOnNC 0 SP!;CXAL'l'Y
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<br />VALUATION or MECBANCIAL 1HSTAt.:r.A1'ION
<br />o OTKIP.
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<br />TYPE OF CONSTRUCTION: CJ BLO<<:K
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<br />D nAME
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<br />CJ STEEL
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<br />o OTHER.
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<br />FINISaEn ~R EL~ION3
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<br />:ts l'ROo71ilt!'l' IN FLOOD IONIt AJU'.l\D YES 0 NO
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<br />BO%IDI:R
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<br />COMPJUlY 'Pnnl Q ("',...,.,a"''P''''~~~ ^or. ,,""" w T.,.,,...
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<br />CITY l'ROCEs:!iINli # 2'1' '1 W II
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<br />SIGNATURE
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<br />I4l 002/002
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