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8�3-780-D020 �il'L'Y p1',��1`!yt'tlill5 i�C:ll��ttit-�jalai��a�,Wa� . ' Bvfiding Do ar�raan( Data Rec�iv�ct �.->U ' f nlzot�o CantactfarPermiti:uzc� �� , -- Sc3�fY �t-t-i-t'i-I-l-hFi'I'I"P(`t"L'L'L'I'(�TT=I9�TPFTnT�i=i=T-'FI=i�-hi-Fi9-i-i-t-i-Mhi-i-i;i-S-(-i�f i-t-(-hPl-i-F-1"(-i-i'1`l-1-! - --- --- 'I-!'I'1---- - - ------- -- - --- --------------. Own�r's Name� ��`�f� f J��.l'ld/7 ��jG_/'�" I Ouirner I'hon�NumU�r � ' � Own�r's Actdress ��7,,3..3 ��Cl�?1 • -�i��e Ouuner Phono T�Iuml�er� � r�e 5impla Titteholcl�r Naine Qwner Phono Nuniber�' � . . • � . r�e Simp(c�7iL•leha]der Adclr�ss . I ' - ' y �3a�.��Dr�css 3 7733 •�eU.�d/� �� `� �.� t^/� `/� c.a-r�t y'd . . , � . f -sur��tvistorr— - - �.Q! �Otizrv�t' f�h—� �.�r�c�c.inr� 35�—aS'—�2-f— �7dJ��— �docYJ--r��'QC1 _(OIITAINGD Cl�ON!PItOPC1�TYTAXNOTICGJ WORl�PROPDSZI] ' t�IGW CCINSTI� Al�l�l�!.T- � SIG1�I [� MOVC � � DGMbLlS!-!" - , �. INSTALL . . � l�LPAIP I pr�onosen u`s�• � � . (� sr-r� • �(• cot� Q ari-ier� � �r�rnc or cor�s-rr�uc-rtor� j� a�.ac�t j� � r-r�� - .[� src�� [� oTi-�Cr� DLSCP(PT1t�N QI=WORI�C ' C Cc.-�' C7��"' fc.S-}G+1� t RGt.�7tQ . ' � BUIi.DlAlG 51Z� �- _� SR T'OOTAC.n� c�� ^_ 1-I�IGI-I'f �r�� � BUILDING .(' ��, �� VALUATIQN OrTOTAI�GONSTIiUCT10N " - � E1.�CTRICAL ;ji . . AIU!!'SC i ViCG � f'E20GRCSS ENCCiGY � � W.ti.E.C. " . � • . Cf �►..Un�Rw� ;G � �ASC�F�ERAi1ITSE�� (813}7�.r-r31�4 • . � MCG!-1A1�lCAl.. '�z VALt1AT ON OC MEC►-1ANlGAL 1NSTALLATlOI� �A7E 1-,�,��324_7�4 �_._._.�.� , , - 0 GAS � i�001=1N� � SI' CIAI.TY � OT!-IGR , I=tNIS1-tED FLOOR,�L�VATIONS � �� CL OD ZONCARCA �YGS �NQ • i3UILDCR � � ' �1, �` COMI�ANY <.SUfJ � 5� _L._/IG- SIGNATUI3C �,�'��'`"' �'�bt�2�� /� RCGtSTGRED Y/ N rGG GUftRCN7" Y/N ' Addrass �-�S / �t-�- �i • I ' . L3cense�/� �—' ~� ELGCTIilCI,4A! . COMPANY SIGNA.TURC RCGlST�RCp ' Y/ N (�GC CURRCNT Y i N Address. � � � Lioons��tf � �� Pi.UMt3CR . . � coNjPAIVY S1�NA"CURG t�e�ts'rsREb Y/ N. �r-cc cur�a�Nr Y 1 N . Acldress Licenso�1 � � MGCI-IANICAL ' • ' CdMI'A�IY SIGN�ITUR,� • REGtsT[c�En Y J N FGE CURRGNT Y i N . Address • .License�t' ��T I OTt-iGT� . ' , COIVtnAA[Y . . , . 51GNA'I'Ul�C RcctsTS�p ' Y/ !� r-ac cuR�cNr Y i N Address , License� � � . _ - - -- - -- --------------- ----------------------- --- ------ ---------- - - -------- -- --- - ---- ---- ----- --- ---- ----- - � RCSID�NTIAL AIFac1�(2j Plot Plans;(2)s�ts of Buifdinc�C'fans;('1)s t af�nerc�y C=orms;R-O-W P�rmitfor n�w construction, Mfnimum ten(90)wori<in�cfays aftcr subinitla!daLe. Requir�d onstt�,CansCruction Pfans;Siormwater P{ans wl Silk I=ancQ InstailerI, ' � San(t�ry Faeillti�s&1 clumpster;Site Woric PermJt fa suUdivisions(Iar�e nro��eis . COMMCi�G1AC Attacli(3)com�Iefie sQts af 13uiidin�PIans ntus a LIf- SaFety f'ac�e;(�1)sel oi�Gnergy'Forms.I�-O-W PermIfiior new consiruction. Minimum ten(9 D}worlcin�days after submitla{da(�. Rec7uirad ansltc,Gansfructlon PIans,S[ormwafi�r Pians w!S11t 1-�nce ins(a!{ed, Sani[�ary f=aci(ities&1 dumpster.Sito Worlt I'erml[�for ai!new�rojec[s.A(t commorcial roquir�ments rrzusL mee(•compiinnco ' SlGitit I',G12MfT Attacl�(2)sets o�Ettc�ine�red Plans. k''�`�!'F?OPEI�TY SURVGY raquir�tl�ror ai[NC-W cans{ruction. � • , ' �1-hl-l-1-l-1,-l-l-{-I-l-l-l-l-1-l-1-1-l-1-Id-I-l-I-l-I-I-I-I-I-I-1-I-I-I-i-I-I-I-I-I-t-I-I-I-I-I-i-I-I-i-I-I-i-I-I-t-I-f-[-i-2-f-I-I-f-�i-t-Sd-1-f-1-1-1-1-1-1-1-l-1-l-I-1-I-1-1-I-1-l-I-1�1-l-hI-I 1-1-I-l-I-I-I-I-I-1-I-I-t-I-FI-i-I-I-I-i-I-1-i-t-I-f-Fl-l-t-I-3-1-1-l-i-1-1-1-1-3-1-l-1-1 U3rectians: , , F!i!out a(�pllcaflon compl�tety. � . Ownor&Gon(raotor sic�n Gac1c ai ap�licatian,not�arizocE ' � [�over�2500,a Nofice of Gomme3�c�mei�t is ra�luireci. (A,/C ul�c� acies ov�r:y5Q�0) k'" Aclenl{fior fhe co,nUactor)or Powor of Attornay(Cor tl�a owner)would Ue someone wtth nofarized Iefit�r�Fram owner autf�orfzing same - •aV�R TI•iG CotiNTG�.C�GC�MtTTlNG (f-'ranl o�f A(�pllcation Only� • i�erovfs ' Sowors Sotvice.Upc�racIes AIC Cene�s(P1aftSUrtrey/C'ootage) , Driveways-Not over Gounter(fi on nub(ic roadways;:needs I�OW i