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<br />Feb-20-07 11:39P
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<br />P.02
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<br />V.'J "'I """"..,.'J.......'.. , .........
<br />l::luildil1!l O"f>llrlnlenl
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<br />Uele Received
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<br />Phone C_IoICI fDr ".""lUing
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<br />.,Jf.'H,.I tJ;6.Itt5",
<br />Owner':; H"rne /11T hr~ ~.A'!; ~. .
<br />/:S""flCd;.... "'&:' L", ~'FW~'I1>>L-"4 - --:I
<br />Owner'eAddress I~ -.- ....J"JiI. I<..e'''r A: - llfl..r. ai"-.J
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<br />Fee Si.nple TlllehDldor N8me[ SA hp ",.' .~
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<br />
<br />/ JOB ADDRESS
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<br />.1
<br />--I
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<br />~nQ Sin,,.I,, TlIlehllldar Addr8l6 I s;,,~ I. I
<br />L.g?t' / ~ r ~ r.. zeJ),;I-o~ Hd.. {. ~ r? ";"3~ LOU r---',
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<br />C ~ PARC:L 10,,1 / I'~ .:J.:~G._ ;ll- c:;p:-~ I eJ(1 (1 - ~ IDe I
<br />~ foeTAIH~O FROM PIl0rPTYTAX NUlI~el
<br />G:Ll NEW CONSTR n ADO/MT D nlGN D MOVt::: D DFMOUSH
<br />lZ"::3 INSTALL r::::J REf"'AIH
<br />t'ROPOSIlD USE D SFH D COMM D OTIII::R L- I
<br />TYP[l OF CONsTRUCTION D BLOCK D FRAME CI STEH D OTHEf( L-.. I
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<br />/DESCRIPTIONOFWORK lAt:10 !J r~S- 5" ~ Or l'tI1c,4'!SO,wp ~ .,.",;'t.. I
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<br />llLlILlllNG SIZE L. . --'I SQ FO~OE I ..... ..~ 1l~~~.,.Lrp""'lI" l'I,".J.n"~~rr""I" ..H.r
<br />... i i i.,... 111.I1"r'I"TI'T"r""r,illl i i ,...1 fll".' ... I 1."""rrrII....'P'II..... Iii..' '0 ~ I rrl'Yl rlllll WI.IIII. _._ _.. .... _ _ ______~__.... .... __
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<br />/ Is / .c'" I
<br />L... / ,<<>0, -
<br />IS I
<br />1$ .-l
<br />I$__~_~
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<br />CJ GAS 0 ROOFlNU D SPECIAL TV 0 OTflF.R
<br />HNISHE[1 FI.DOR ELEV^TIONS I _ ,J Fl.OOD ZONE AREA DYES DNa
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<br />~~:~~I~::l"" "''''~:::~~~ "'/1 ~~1~5; '~ttI!_i1f II,. ::111,11111 ~I:::~ Ill~~~'H'n' 111111111111111111111111111111111" " 1111111111111,
<br />:'IC;NAT E : ,A~ _ ~ ._ RE6a:;,...tJI I Y / N rr~ C:I)RRENT L.YLEJ
<br />^Ild,eu _~_.____._____. _. L1cen&6# .1
<br />
<br />eLECTRICIAN I COMPANY I
<br />SIGNATURE. I REOISTERED Y / N fEF.&iiiRBfT ~
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<br />Addr...& I '--1 Ucenoe # ...--,
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<br />I'LUMIolER ,..., '~--'-"-----'---'---'-"'-'-I COMPANY --..-...-.. .'--,
<br />S'GNA'IUI(!: __.____ REGI~ICREU VI N r-FfF.Ci~;U;NT' ~
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<br />AlloJr",. I . --.-- . --I Uc&na611 L___. '1
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<br />MEC.,ANICEAL L I COMPANY Y I N =. .......J
<br />SIGNATUK ______, REGI6TEflEll FeIiCUIlRENT
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<br />Addnl&$ I ~.__._-._--_..~ License. I
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<br />OTHER I -.- - '-=r-:::~y I
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<br />SIGNATURE ---.J REDlliTEREO 1.~_1 FEE CURRENT L.YL.!LJ
<br />
<br />Addr1l8e L___..... ---.-......--.--..-1 ll""",."JI I I
<br />1111111111 J 1111' 111111111111111-."""""111111 11111111111111111111111111111111111' 1111111111111111 11111I11111I11111111111111111111 '1111' 1111111'
<br />RE:SIDENTIA1. A""ch (2) frIo I f'lan&; (2) lela 01 BLJllwlIY PkI'l:l: (1) set ur GII"",)' FUlIll.
<br />Minimum len (ill' WOlklng dB'18 liner sul",,;I...1 WiD. Aa~ui,ed o""il~. Cu".IrU~1lu1l PI",IS, Sa"il.ry r:adlll;". & 1 oJum",'ar
<br />AIlaCII (3) SBIS or BuIlcIlng Plllllt; (1) ...1 ur E.....y F""".,
<br />Mlnlmum len (101 wod,;.~ day. aRar ",lbmIU,,1 d"'A. Rm]uirQd nn$lIn. ean.ln,rJjn" PI~Il$;, S"n1'"ry f'"clIllk>$ .. 1Iltll1l"$18I"
<br />All commercial requlremenla mldllnlllel CDlII"ltlII"".
<br />Allach (2) 6el& or Englnae,8CII"B'I>l.
<br />....PROP[lRTY SURVEY requlNe! lor all NEW ""nsuUCllon.
<br />U,~~~~I~~~I:"I1HttfoHoH.~.......tttlllll""11111111111111111111111111111111111111111111111111111111111111111 JI 111111111111111111111 111111111111
<br />
<br />Fin 0111 """lIea~lIn llOf11plelely.
<br />Owner II Conlraclor aign back or apptlcellon, noIllIIZed
<br />" ave, $~liOO. A NOllee of CommencemA"I's requIred. (AlC upgr.des uver 150001
<br />IIS,,"I (lor InG r.onlr.lClor) or Power of Allamel' (rOt' P,e uwnerl waLJ11l IHt !I0ll1eulle W1UI II0lar1l.ecJ 'ell8r trom owne, 8u\llonZlng 88me
<br />ovm TItE COUNT[lR PIiRMITTING (Fronl oll\ppllc:alinn Only)
<br />Ren'lDf:;. SC1Wlfr.; Sn~(\ LJpgrade& AJC
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<br />Owner Phono NlImber
<br />
<br />Owner Phonn Numlle.. C'
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<br />OWner Phano Number I _
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<br />SUDDIVISION
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<br />WORK PROPOSED
<br />
<br />o
<br />
<br />BUILDING
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<br />VALUA'1I0N OF TOTAL CONS I HUCTION
<br />
<br />D
<br />
<br />El"CTRICAl
<br />
<br />AMP SE:kVICE
<br />
<br />L__I
<br />
<br />PROGRESS ENER[]Y
<br />
<br />D
<br />
<br />W.RE.C.
<br />
<br />D
<br />D
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
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<br />VALUATION OF' MECHANICAL INSTALLATION
<br />
<br />COMMERCIAL
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<br />SIGN f'I;HII1H
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<br />F..".,,,,, (plnVS.."'aylFoulaye)
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<br />DrivBWllys-Na' over Courder IF an public ra;adw..y.:;.."41n(f$ H,(JW
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