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, ' <br /> ' ' � <br /> � <br /> II <br /> i <br />, , <br /> ' s��-�ao-oo2o City of ephyrhi!!s Permi�Application Fax-813-7$0-p021 <br /> Building 4eRartrnent � <br /> ei ed I �� �'�� _ �.�i�r <br /> Date Rec v Phone ontact tor Permittin 7 S � <br /> -�--�-�-�'-�-g-X-e- i' <br /> OvrmersName ���t''L� �' �'� �rfy��" � Gv✓nQrPhoneNumBer <br /> IOwner'sAddress ��'�� ��`��Y't'�'� I OwnerPhone Number �- �� <br /> I i <br /> �'ee Simpte Titlehotder IUame Owner Phone Number <br /> I i <br /> Fee Simple Tittehoider Address ( <br /> JQBAQDRESS •�S�'Zf� �f� /�'VE`• 40T# � <br /> I susatv�s�oN ����.� p�cei:�I# 1� -�G-.21 -�QC3J t�-JL 7D�-Da J t� _ <br /> (OBTAINED FROM PR4PERTYTAX NOTICE� <br /> WdRK PROPOSED e NEW COt1s1'R 8 ADdIALF �] S1GN � Q DEMOLiSH <br /> INSTALL REPAlR <br /> � PROPOSED USE 0 SFR � COiviN! � dTHEi2 <br /> TYPE bF CONSTRUCI'(ON Q BLOCK � FRAME 1 � STEEL Q � <br /> OESCRIPTION OF WORK --�t�'Y"'°s' ��°w ti ans��l�e�. �V�-�. pt tun b � rywG!!1 �r c� <br /> BU!l.pENG SlZE. i � SQ FOOTAGE 1�,i.� HEiGFiT ��� . <br /> ¢``;� �St31LdING � V UATIO�t.O�TQTAL GONSTRUCTi�N <br /> ;� � <br /> t <br /> ~�� QEIECTRtCAI $ APd SEF2VICE � PROGRESS ENERGY CJ iN.R:E.C. <br /> � ri <br /> �PLUMBING S <br /> � <br /> ' <br /> iQMEGHANJCAL � ,� VA ATIQN O I{bTECHANfCAf.iNSTALL'ATION <br /> . QGA5 Q ROQFING C] SPECiAL7Y 0 dTHER ' <br /> � �Ily FINISHED FLOOR.ELEVATIONS FL.dQd'ZONE AREA �YES NO <br /> � I <br /> i �utLnett � cot�r-��AtvY L'�c�.ss �.ausT',eueT'�a� C�'iPR-NY..�- <br /> SIGNATURE R�G�STtsRE� Y!,N �ES CURREn Y t N <br /> Add�ess .2522J Lt�E-.,1� ,(37v . La,i�',� 33559, Licectse# CB�,' l2S�G,37 � <br /> ELECtRtC1AN f � COM�ANY ..��P E�"��..T�•l+C� .LA1'�'... <br /> StGidATLfRE � � RE�IST�s�a Y i N ,FeE CU��n Y!N <br /> Address � C3/L�. FGD,ClL�x1 A�y�, T� ('A- 33 G��{ License� �L' E,�E��D 7�5�, �—.� <br /> � �i� +��'f5"t��st: f�tY?L3lhl� � <br /> _, PLUMBEF2 COMpi41JY <br /> Sl{�arNATUR� REOISTERED Y/ N FEE CURr�E�� Y I�I <br /> t <br /> .Aiidress !22 0 f(�'.�',`-r-��i"" f;s-tam r3 r.�2 i 3�4 8:3: Lioense.#.��'r�-��.�'%`��� <br /> 'r�.MECFIANICAL � COMPANY ��7�7 :S�V�iCE.S ���- <br /> ASIGNATURE REG�s'iERED Y! N FF�CURREP Y.tR! .. <br /> i <br /> Address ��j-5 ��1�2T�a.� LitTtr�,2.�j tr- �y�� T,�tv�4 33�03 uce�se# �� � <br /> OTklEFt COitlIPANY <br /> SIGNATURE � R�6ssr�o Y! N F��CuFt��n Y i N <br /> Address License#������ <br /> i '/ Oi1lldfDtsllflQ $ iIiBlDiiiiOtt � / iUi-9it7C { titlTilt / 08 .i1'Oti'/'Ditfli'/ f <br /> RES1DENl'lAL Attach{2)Pi6i Plans;.(2}seLs of Buiid9ng Pians;(1}set of Ettefgy Fotms;R-O-W Permit for new construction. <br /> Minimum ten(�0}working days after submittat ate. Reqvired onsite,Conswction Ptans,Stormtivater Plans wl 5ilf Fence instatled, <br /> Sanitacy Faalit'se"s&1 dumpsfer,Siie Work Pe ic ior_subdivistons!(arge projects <br /> COMNlSRCtAL Atiach(3}cflmpleie sets of.6uEldirtg Pfans plus Ute 9afetyy Page;(1}set of.Eaergy Forms.Ft-0-1N Permit tor new canstruction. <br /> Minimum tan{14}wotliing Qays afte�sul�mittal a1e. Require8 ansite,Construct€on Pians,Stamswafer Plans wJ Sitt Fence instailed,. <br /> Sanitary FaciliUes&1 dumps#er_8i#e Work Pe it far aU neiv projects.AE(camrnerciet�equ"irements rnust meet comp�2nce <br /> SIGN AERMIT AttaCh(2}sets of Engineered Plans. � <br />