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, 873-780-002D Ci1:y a1',��pnyrn���s r�r1��s��N�u���,�„ • <br /> ' 8uiiding Dapartment <br /> pafe Rac�ivecl _ _ _-- --- --- - -- 1'hano Contact for Permitting Fj•� _ !�. — 1`�I��ze�.rlt_t1:L-ti-r <br /> �i-htii-Fhfi'1'Fhi'i-i' '1!!`i-hl-l-l��nTFr��t i rr �.t�=^ ' <br /> Owner's Name f"�-Gt! � Owner Photte Number ��� �y ?'-��� ' <br /> Ownc�r's Acidress ��� o„�.GutAlN.tl� • �/`' Ownar l�hone Number C,� � <br /> 1=ee 5impfe TltlohaldQr Name • Owner Pt�one Nurriiaer��� I <br /> C'ee Sirnpte TiClel�older Actdr�ss ' • ' <br /> JO[3 ADDR�SS rP(�J • �C,J/1 f),( �t,E' Ar � � � � ��T�k �/��� . <br /> suBUtvistoN � • ��j�a G►�-� ,� .�'`t�` � PAttC�LiQ# fJ,.�—ab-d,/—�71•.7d—dG�—�' <br /> . . ' (qDTAINF.!]FROM PROP�RTYTAX NOTTG�j <br /> WORK PROl�OSCD ' NGW C�NSTR ADD/ALT [� SiGN � MOVE � DGMOLISI-1 _ <br /> �. INSTALL • . � PGC'AII� <br /> PROAOSGD t7S�' . � SFFt ' �• COMM � C?ThlEC3 ' <br /> TYPG QC GONSTltUCTIQN �J BLOCt� � FRAMG ` .� , STEEL [� OTI-IEl� <br /> D�SGRIP7'!ON OF WORK ' �+2 C� ,ja2- Gt>/�.�� � c.r Z.c- � r J' ?,� �.1L- �� /��- <br /> C�UILD{NC SfZG ' SR FOOTAGC���,� I•I�IGI-(T �____� <br /> BUII.pING � � ��-�� � VALUATION Qf=70TAL CONSTRUCTION <br /> Q ELCCTRlGAL � , �� AMP SCt-tV{CG J� nRa�ft���c��RM��E.C. <br /> (813)78B•6314 ' <br /> C] PLUMBW� a, �i 1r��s'f� <br /> ��_��� �� - . <br /> Q M�ChiANiCAL �; VP�LUATiON OF MEGHANICAL 1NSTAl.LATlQM . y`� <br /> . � . , ,� t . . <br /> � �as ' �J r�aar-i�r� � SP�CfALTY � orrie� , <br /> C'INISI-!ED FLOOR GLCVATIOl�IS � ~� (�L.qpD ZC7NE AREA DYCS �NO - <br /> BUlLD�R. � ��� c GOMPANY f J � �G . <br /> SIGNATUTtE C�>���G'1� �2CGI5TERED Y/ N FEE CUftRENT Y!N ' <br /> . - <br /> Address �L o�?� (�, ,(1t.- �� • • . Llcense� � � <br /> GLGCTi2►CIAN . CQMPAN� <br /> SlGNATUT�C �tSGtsTERED ' Y! N �=e cu�r Y I N <br /> AddrQS� � � Liconso# �� � � <br /> n�.UM13L-R . } CQ1Vl�PANY <br /> SIGNA7"UTiG ItCGlsTERE� Y I (V� FEE CURftENT Y/N <br /> Address License# ��i i� <br /> MECI-tANiCAL ' • ' COMI'Ai�Y <br /> 51GNATUI2E • r�E�is7tRr-� Y! N �r-�GUr�t3cuT Y(N , <br /> Acidress . . .License#' �� � <br /> OTNCR . ' . COMPANY . . , . <br /> S1GNA'i"URE I�CG(STCI�ED ' Y i N r-c�cuR�cNr Y!N <br /> Address , License# �^ � <br /> RCSiD�NTiAL Aktaol7(2)Plof Alans;(2)seEs of BuIiding I�lans;{1}set of Gnargy 1=orms;R-O-W Perm3t ior new cons[ruction, <br /> Mlnlmum ten(10)woridng days afEer submitfiai date. Required onsIto,Ga�strucEIon Ptans;Sfiormwater Plans wi Siifi Fence tnstailed, <br /> ' Sanitary FacillUes&1 dumps�er,Site Woric Permlt for subdivisionsllarge�rojec�s . <br /> COMM�t�CtAL A#t�tcfi(3)complete seks of Building Pfans plus a Liie Safety i�age;(1)set of Enorgy'Forms,F2-¢W Permtt for now conslrucUon. <br /> Mfnimum ken(10)wor!<ing days afEer submiEtai dafi�. Rec�uireci onsfte,Construction Plans,Stormwator nlans wl Spt Fence lnstalled, <br /> Sanitary 1=acilifies 8c'i dumpsfer.Sito Wark Permit for alf new prajecls.All comrnerclal requir�m�nts must meet compiiance <br /> ' s]GAI PG1iMlT AEEmch(2)sefis ofi Enc�in�ered Ptans,� <br /> "�*"t�FtOPERTY SURVEY required for a!!NCW construction. � • . <br /> ' -t-i-i-1-1-f-t-i-hFt-1-i-H-hMf-M-t-i-FW�f-t-t-I-l-t-l-i-Fl-H-3-1-1-t-1-l-l-li-1-l-1-!!-!-l-I1-l-l-1-I-1-hI-l-t-I-Fl-I-1-I-1-hi-1-i-I-1-i-t-1•t-i-f-i-H-i-i-I-f-3-t-1-t-t-i-ht-Ft-I-i-f-l-l-i-l-l-i-t-1-1-i-l-l-l-1-i-l-H-�d-Hd-l�l-J-�-l-l-I-hl-l-hl-1-1-I-Ft-i-t-1• <br /> Dirocttons: <br /> FiU out appfication complately. � . <br /> Owner&Gontractor sfc�n�aalc afi apnqcafian,nofiariz�d ' • <br /> IF over�25�0,a Nofico of Gommenc�mont is roqair�cl. (A/C upgracles over:GS000� <br /> "' Agonk(for the co,ntracLar)or Power of AtEorney{for fit�o owner}waufd be someone with notarized letler fram awner authorizinc�sam� - <br /> �OVGR�"(-!C COUNTCR I'LRMiTT(NG (1=ront of Appi€cation Only) � <br /> i�eroofs ' Sewet�s Sorvice.Upgradas A!C l=encas(1'lofilSurveyll=ootag�) . <br /> Driveways-Nak over Counter ii on pu6llc roadways.:needs ROW <br />