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813- 7800020 City of ephyifaiIsFY Fax-813730-0021 <br /> • Permit Application <br /> Dais Received .((1A <br /> ownerm tuns D , _.4..1n7 Orste�+s Phone Number 1 6!-/-3 t 1 `P,t I ] // // <br /> Owner's Adc ss j ,YBYo / 5 ,67,45/Ar <br /> Fee Simple1lwaroiderName 1 17iboid.r Phone Number 1 11 11 <br /> Fes Skra islilwiokNrAaa ass <br /> F _ �_- <br /> Job Addrrrra __ __ _ _ ____: _______ , ______ _______ _______ . - 11ffillE <br /> Sub Division Parcel # • <br /> .� / � <br /> Q B io4laed Wale slorape - ANNUAL R nip lion Tent <br /> Q COMM edmrst tQdten HoodlDnct C] H uscdons Wald (Tier II orRO Fe>r!y) <br /> Q C onrol edBum 0 Hood iwdeaort • <br /> Entsep Grnerakt430Iow LPM�Irralans lsaon <br /> 6merprnoy®.nwalor> 30 kw LPDtessarai AerNW. suds <br /> Fine Probcaort Meii.rtc& <br /> .n- ANNUAL - Ream of A..eably,AMINUAL <br /> & .. III 0 ® - ftsa.diond Burn <br /> Are Alan 11111 0 0 0 IIIII spsldsm <br /> Hood cla.rbp '.D D 0 Al 1.11 S er lend ions <br /> Hoods �' 0 0 startdpipes (SNudnkier ) <br /> Flie Atom hehlrast • Tomb Roofing/Tar Kellis <br /> Fir. Pumps Warts Tie Sloop ANNUAL <br /> .... Fins Works <br /> Fkmsnable apicallon- ANNUAL lfait,aiion Project <br /> ` Fuel Tanks <br /> . 0 other: I <br /> Contactor I y <br /> Siamese Rsy6lsed I Y/ N ! Fee Conant 1 Y/ N I <br /> Address ! <br /> 1 License* . 1 <br /> 1 • ' 1 - 1 Repetad Company <br /> sianntuELECire Rlpiste Y N • Fie Cassia Cassia <br /> Adrian; I <br /> 1 Manse* I <br /> Company <br /> R. I <br /> Regained Address 1 <br /> • <br /> 1 Lana* I. I <br /> MECHANICAL' • <br /> I Company .. <br /> Registered l YIN 1 Fee tenant E Y/ N 1 <br /> maims I 1 License <br /> OTHER <br /> +ro+e VIMIW,..,.(0..4.43.1.-Z._ <br /> ► S = • - r E'. , . <br /> - •�...�...� Repar d I ii Fee Cement MjLZ1 <br /> Address 11 7 - •W V Mili if- License# Ir <br /> O aclons: <br /> RI Omar Cow application Pun book dsppl allon. adhere d (On copy deigned contract wt h owner) <br /> If aver 12500, • Hoke of Commencement le requ ed.(Meehenigr wak over 35000) <br /> Supply Iwo (2) ewe a/drawings lea apptloable docesomaaion <br /> Alum 10.94 drys for review ear edemas, dude. Parcel* - obtained bun Paws* Trot *ace (hlpinpprai..rp.saopow.00m) <br /> • <br />