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r <br /> 813-760-0020 City of Z phyrhills Permit Application FaX-a�a-TSO-ooz� I <br /> _ � 8u0ding Dapartrnent <br /> � �' ' <br /> ' � Date Received ptio�re ntaet(or PertnlWn 863 581 7544 <br /> owners Name SALLY ANN DEHRING owner Pnone Number 269-591-0351 <br /> I owners�►ddrese 12677 N RED BUD TRL BUCHA N MI p�brPhone Number <br /> Fee Slmple Titleholder Nama N�A Owner Phone Numher <br /> � <br /> I Fee Slmpie Tlilehalder Addroaa wA ' <br /> J08 ADDRE$S 38553 REMORA AVE toT r �� <br /> sueomsloN SLEEPY HOLLOW MHE p���ioy 02-26-21-0260-00000-0710 <br /> �oar�en Faod vROa�cn T�x Nonc� <br /> WORK PROPOSED e r+tw cOnsrn 8 ADD/ALT Q SIGN Q Q OEMOLISH <br /> " INSTALL REPAIR � <br /> PROPOSED USE � SFR Q COMM Q OTHER � <br /> TYPE OF CONSTRUCTION Q BLOCK Q' FW1ME Q STEEL Q ��r/��� �p � , <br /> V�(V� <br /> oescwPnoN oF woRK SET AND ANCHOR 20 5 24x54 PALM HARBOR MOBILE HOME � �i1�"�( ►�i, <br /> �tr�v <br /> BUIIDING SlIE 24 X � SQ FOOTAQE 980 HEIGHT 11� ����� <br /> �BUILDING S SOOO.00 V lITION OF TOTAL CANSTRUCTION <br /> QELECTRICAL S p �D� AM SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> �PLUMBING s 500.00 , �J � ��, <br /> . �� _��Tl� a��� <br /> �MECHANICAL S 2000.00 � ATION OF MECHANICAL INSTALLATION ( Z � � <br /> QGAS Q ROOFING Q SPECUILTV � OTHER � � (�� .✓� <br /> FINISHEDFLOORELEVATIONS � FLOODZONEAREA QYES NO �7, p {�`� {`]� <br /> ✓ �\I �—� <br /> �`7 <br /> aui�oER coMPa�n . PALM HARBOR CONSTRUCTION <br /> SIGNATURE I� REGIS7ERFD Y/N �E cuft�ten Y/N <br /> nddr��5 605 S.FRONTAGE RD PLANT ITY u�r,�u IH-1025311 <br /> ELECTR�CUW � L�C1ai.�� COMPANY SMECREST � <br /> SIGNATURE r�cis�� Y/N �cuw�. Y f N <br /> Address 2450 ENTERPRISE ST FREMO OH uceruett EC13006070 <br /> PLUMBER //�•� �p�y�ppp�y PALM HARBOR CONTRUCTION <br /> SIGNATURE l/'` r�G�57Et+ED Y/N �E cuar�n Y/N <br />' nddreaa 605 S.FRONTAGE RD PLANT C TY ucenseu IH-1025311 <br /> MECHANICAL �'/ `� COMPANY STYLECREST <br /> SIGNATURE �lL r+ECU�nEn Y/N �cuar�n Y/N <br /> Addresa 2450 ENTERPRISE ST FREMON OH ucensen CAC1817820 <br /> OTHER COMPANY <br /> SIGNA7URE' �c�sr�o � Y/N �cuw�n Y I N <br /> Addroea LJcense# <br /> RESIDENTIAL Altarh(2)Pbt Plens;(2)seb of Bulking Plans(1)set of Energy Forms;R-0-W P�mit for new coruWction, <br /> Mlnlmum ten(10)worfdng days after submlttal te.Requlred a�slle,ConsWctlon PNans,SMtmwater Plans w/Silt Fence Inslailed, <br /> Sanitary Fadiltles 61 dumpsler;Site Work P it for subdMsloraAarga proJeds <br /> COMMERCIAL AlNach(3)mmplate sets of Bullding Plans plus Life Safety Page;(1)set af Energy Frnms.R-O-W Pertnit for new consWctlon. <br /> Minimum ten(10)woAdng daye after eubmltfal te. Required onsile,ConsWdbn Plans.Stortnwafer Plans w!Silt Fence installed, <br /> Sanlfary Fadlitles a 1 dumpster.Site Work P It for aIl new proJeGs.AII commerdal requirements must meet compliance <br /> SIGN PERMR Atfach(2)sets of Engineered Plans. <br /> "«PROPERTY SURVEY requlred(ar ail NEW nsWcUon. . <br /> Dlrectlone: <br /> Fill aut appliptlon complelely. ' � <br /> Ovmer 8 Contractw sign badc af applicatlon,noharhed <br /> If over S2S00,e NoUce of CommencemeM Is requlred. ( C uppradea over s7500) <br /> " Agenl(for fhe contrador)ar Power of Attomey(for the owner) uld be someone wlth noharfzed leqer hnm owner authorizing same <br /> OVER THE COUNTER PERMrtTING (Front of Appllqtion O ) <br /> Reroofs if shingles Sawera Service Uppradas AIC ences(PIoVSurvey/Footage) <br /> DrlvewayrNot aver Counler if on public madways..needs R W <br /> : . . <br /> • • i. . . • — <br />