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450 Towne Center Cir 95-104 (a) NEW AUTO CENTER (2)
60 8 Aks f- i ZONE DATE CONTRACTOR %t ADDRESS 1 rJiL-h Id l c A PHONE #' Q`+ LOCATION Q OWNER- ADDRESS PHONE # cf PLUMBING CONTRACTOR ADDRESS PHONE # l d 61ec -%cal J /` ELECTRICAL CONTRACTOR _ 1 ADDRESS PHONE # MECHANICAL CONTRACTOR ADDRESS PHONE # MISCELLANEOUS CONTRACTOR ADDRESS. /99f 6.2. zz z/ &/ C,C17/ SEPTIC TANK PERMIT NO. SOIL TEST REQUIREMENTS (__) FINISHED FLOOR j SUBDIVISION: PERMIT # LOT NO.. JOB c & a AwLo 84aBLOCK: COST $ d0 SECTION: Cl , FEE $ STATE NO. FEE $ 13 FEE $_ L_L_ FEE $ SQUARE FEET: MODEL:, OCCUPANCY CLASS: INSPECTIONS - I TYPEDATEOKREJECTBYFEE $ ENERGY SECT. EPI: Sqn- ELEVATION REQUIREMENTS (_) CERTIFICATE OF OCCUPANCY ARCH I i ECTURAL APPROVAL DATE: ISSUED # / DATE: FINAL DATE 0 b U b 0 a Z 0 CITY OF SANFORD, FLORIDA APPLICATION FOR BUILDING PERMIT PERMIT ADDRESS V VWn k_4 it dePERMIT NUMBER10 Total Contract Price of JobSlc/ Total Sq. Ft. 41W 5•F Describe Work Co,.v-57ageTlon pt t-ro .www Type of Construction General Construction Number of Stories I Number of Dwellings Occupancy: Residential Commercial P/ Flood Prone (YES Zoning _ Industrial LEGAL DESCRIPTION (please attach printout from Seminole Count TAX I.D. NUMBER 57-0509435 OWNER Sears Roebuck & Company PHONE NUMBER 312-875-1803 ADDRESS Sears Tower, Dept. 824-FC CITY Chicago STATE IL ZIP 60684 TITLE HOLDER (IF OTHER THAN OWNER) N/A ADDRESS CITY STATE ZIP BONDING COMPANY N/A ADDRESS CITY ARCHITECT ADDRESS The Butner Grou P. O. Box 2109 STATE CITY Montgomery STATE MORTGAGE LENDER ADDRESS CITY N/ A STATE AL ZIP ZIP 36102 ZIP CONTRACTOR Suitt Construction Company, Inc. PHONE NUMBER 407-834-2300 ADDRESS 270 S. Northlake Boulevard, Suite #1004 ST. LICENSE NUMBER CG CO28786 CITY Altamonte Springs STATE Florida ZIP 32701 Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL, PLUMBING, MECHANICAL, SIGNS, POOLS, ETC. OWNER' S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT.HAS BEEN ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR THE IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. s C u c a 3 o E ro o Z > H H ro w n C O u ` 0 4J u 04 o o -;, Z a F CCEPTANCE O PERMIT IS VERIFICATION THAT I WILL NOTIFY THE OWNER OF THE PROPERTY OF HE REQUI NTS O FLO IDA LIE LAW, FS713. Or Or **** ********* **** D / CG Signature. of Owner/Agent & Date S n tune of Contractor & DatA- r- E l Cam. ScviSclglC Rex Kirby Ty e or Print Owner/Agent Name Type or Print Contractor's Name Sign e of Notary & bate Signature of Notary & Date Official Seal) (Official Seal) MOM 1hibliS, gA0$4t of T6469 a V cf F a r} Get.x7, 1999.r s°, ,,. 2, 1995 BONED Elnd t. !lr., i 33L€C UNDERMUTER& Bonded Thru Troy Fain - Irscrarce Inc. Application Approved BY: Date: FEES: Building Radon Police Fire Open Space :Ro:a dd act Application PERMIT VALIDATION: CHECK CASH DATE c,Z C{ BY ORIGINAL ( BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX FFI ) GOLD (CO. ADMIN) A y ro Z 10 m o n o 0- 0) n O rn J W K H H F Ul K x Z 3 D O^ ro o n o+ rt 0 THIS APPLICATION USED FOR WORK VALUED $2500.00 OR MORE ADDENDUM OWNER: SEAR' S AUTO ADDRESS: 450 Towne Center Boulevard DATE: September 14, 1995 REASON FOR DISAPPROVAL: CONDITIONAL AGREEMENT: Items to be completed ' prior to ' the SOFT OPENING September 15,1995: 1. All stop signs require a stop bar. ' 2. Bulk clean up of the parking lot of debris and trash 3. .Conditions agreed to by Joe Cooper / Simon. oe Cooper / A ENGINE NG L NI I MANAGER y i The Building Department has prepared°a certificate of occupancy for the -above locationandisrequestingafinalinspectionbyyourdepartment. After your inspection, please come to the Building Department to sign -off on the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has beendenied. ° Your prompt attention will be appreciated. Thank°you. . Distribute Engineerin ° Public Works ° Utilities/2z)/rj Ce,1-).j-echc) ° Zoning Date Started- Cl T1( OF SANFORD, FLORIDA Request for Finag IfiS ection for Certificate kof occupancy ADDRESS: The -Building Department has prepared a certificate of, occupancy for the above locationandisrequestingafinalinspectionbyyourdepartment. After your inspection, please come to the Building Department td sign -off on the ° Certificate of Occupancy, yor submit a certificate of -occupancy addendum if it has°beendenied. ° Your prompt attention will be appreciated. Thank you.,:° DistribuLon: Engineering ublic_VVnrks Utilities 2CJ/YJ /L_eCzhc):. ) Zoning ° ° ° ®° ° ssrsp°°sUks Date Started - MY OF SANFORD, FLORIDA ° 1equest for nak inspedlon°fora . ADDRESS: C The,Building ®apartment has prepared a certificate of occupancy for the Fabove locationandisrequestingafinal °inspection by your department. ° After your inspection, please come to the Building. Department to sign -off on the ° Certificate of Occupancy, or submit a certificate of occupancy addendum if it has beendenied. Your prompt attention will be appreciated. Thank you: ° Distribution: Engineering mire Public W rks Utilities V2z)1Yj °G,lj-.ec z Zoning ° ° ° The Building Department has prepared a certificate of occupancy for the above locationandisrequestingafinalinspectionbyyourdepartment. After your inspection, please come to the Building Department to sign -off on theCertificateofOccupancy, or submit a certificate of occupancy addendum if it has beendenied. ° Your prompt attention will be appreciated. Thank you.° Distribution: Engineering ° Fire 'K Public W rks 11-e cz.J Zoning . Date Starts • /" , n n d. Y (( Y ° CITY OF SAN ° I/U FORD, FLORIDA , Request for Final Inspection for Certificate of Occupanc ADDRESS: The Building'Department has prepared a certificate of occupancy for the above locationandisrequestingafinalinspectionbyyourdepartment. After your inspection, please come to the Building Department to sign -off on -the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has beendenied. ° Your prompt attention will be appreciated. Thankyou. DistribuLon: Engineering ° Fire Pblic: W tilities,, Zonin I po Date Started. 7 The Building Department has prepared a certificate of occupancy. for;the above locationandisrequestingafinalinspectionbyyourdepartment. After your inspection, please come to the Building Department to sign -off on the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has beendenied. Your prompt attention will be appreciated. Thank you. Distdbuton: Engineering Fire 8 /)J,9 V S 7, so Cze: a i y s Date Started: ILC4 CITY OF SANFORD, FLORIDA Request for Final Inspection Cedificate of Occupancy ADDRESS: D -T The Building Department has prepared a certificate of occupancy for the above locationandisrequestingafinalinspectionbyyourdepartment. After your inspection, please come to the Building Department to sign -off on the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has beendenied. Your prompt attention will be appreciated. Thank you. Distribution: Engineering Fire Pubfic Works _ _ , utilities Zoning Date Started: 2-i The Building Department has prepared a certificate of occupancy for the above locationandisrequestingafinalinspectionbyyourdepartment. After your inspection, please come to the Building Department to sign -off on the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has beendenied. Your prompt attention will be appreciated. Thank you. Distributon: Engineering Fire Public Works Utilities Zoning _-s a CITY OF ,CANFO3*0, FLORIDA APPLICATION FOR BUILDING PERMIT PERMIT ADDRESS Total Contract Price of Job I ILXW — Describe Work Ist(J soh PERMIT NUMBER I V Total Sq. Ft. ZZI Type of Construction _Aa-,,) Flood Prone (YES) (NO) Number of Stories T_ Number of Dwellings _ Zoning Occupancy: :Residential Commercial Industrial it - LEGAL DESCRIPTION LA1J (please at printout from Seminole Count TAX I. D. NUMBER I ICJ 1.7-LT) / I ` n OWNER _ ADDRESS CITY I TITLE HOLDER (IF OTHER THAN OWNER) ADDRESS CITY BONDING COMPANY ADDRESS CITY ARCHITECT ADDRESS _ CITY MORTGAGE LENDER ADDRESS CITY STATE STATE STATE STATE PHONE NUMBER ZIP ZIP ZIP ZIP CONTRACTOR PHONE NUMBER' ADDRESS b ST. LICENSE NUMBER-Fe)OD7)/3 CITY STATE ZIP 7- , -?b Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL, PLUMBING, MECHANICAL, SIGNS, POOLS, ETC. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating Construction and zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED' ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR THE IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as`water management districts, state agenciel, or federal agencies. ACCEPTANCE OF PERMIT I THE REQUIREMENTSg1 Fr*** **** J a a 3 o N G E 4 Q r-i H m -1 ro w C O 4 o ro o 0 0 4 a o N >1 z w H Siailakur TftA or Pint VERIFICATION THAT I WILL NOTIF EN LAW, FS71 r/Agent Dade ;KzgnAt.0 Agent Name T Signhture(Iof Notary & Date Official Seal) q L. MUSE NOTARY PUBLIC, STATE OF FLORIDA MY COMA MISSION # CC132860 PI E;?: August 4,1995 APr t-r0Tr--Appro ea Y : FEES: Building, Open Space PERMIT VALIDATION: CHECK Print Cont OF THE PROPERTY OF 3 ro 2 1< m o b n rt 26 m n a o n for Dat o 5 M a - LLA Z cA111 z actor's Name a x o co 0 4G o ro o n Signature of Notary & Date ~' 0 r5t t is iaTSea I rt MARY L. MUSE t NOTARY PUBLIC, STATE OF FLORIDA ° MY COMMISSION # CC132860 EXPIRES: August 4,1995 i Date Police Fire Ap 1' ation DATE ' BY ORIGINAL'(BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFICE) GOLD (CO. ADMIN) Radon Road Impact CASH n r+ m a, a ITHISAPPLICATIONUSEDFORWORKVALUED. $2500.00 OR MORE U \L-t-fY. 13 MM WH ITS -WMDIJ T1JP l tkcdxz pU R-i''P. T'1=1z- L U. I-. P\-P. 8. K•tA 5EF4t=-5 r72a _ Gffc-nc j VI M/\/ A o65 ALUM NUM . R-ffTLJWJS yZ s---rrc- f=Lf- 17l-f-:r- GvNT7U T - 7D T74 MA,-Wl-e =Uocuow DIsG. sW 11;C(A*1 f,`iF A1 iS, zZ/X 21'XYj! ,A-L-U ham. tMoU "-n "c, GL-\ PS M o u W i-, 3/a1) "ro 6rt) 4 w wrOt yly A Mk DRAW1110 ROPt RT/ OF UNIVERSAL UNtiMITED, IIIC. 1t ot.l l.rn CLIENT 5.—n.. i lNLE r a L DRAWING NUMBER OATS c•o..Vr.At' DRAWN BY T CLIECKED by 3 SNEET NUMBER OF Ain REF DwD SCALE UNIVERSAL Uo&flwft-r-ffC n_aA PRAYI OVAL, GLEN COVE, N.Y. 11547 15151676-6400 1141S DnAWINO AND All Nn ORMA11O1: 11IEREON 15 T..E PRO"RTY OF tINIVEnS At UNMAN ED. INC AND SNAIL NOl BE COPIED On USEDEzCFPT Eon 1NE PURPOSE FORIVIUCNN IS E1tPRE55LY FUnNISNED, IIIE UnAWING AND ANY COPIES T1IEnEOF IPANIIAL On COMPLETEI SMALL OE REIURNED TO 111E OWNER 104. DEMAND CITY OF SANFORD, FLORIDA PERMIT NO %±02f / 3 1, DATE 12/2/94 THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE FOL- LOWING PLUMBING WORK: OWNER'S NAME Sears. Roebuck & Company ADDRESS OF JOB Auto Center -326- Towne Center Circle PLUMBING CONTREllis Mech. Cotes. Comm. X _ Subject to rules and regula4ions of Sanford plumbing code. Residential: Alteration, Addition, Repair New Residential: I Number Amount One Water Closet Additional Water Closet Commercial: Fixtures. Floor Drain, Trap 121 0 Sewerr Water Piping -- Gas Piping Factory -built housing Mobile Home Reinspection APPLICATION FEE 1 Minimum Commercial Permit: 4MM Total aj Q Master Plumber William R. Ellis COMPETENCY CARD NO. CFCA21520 0s CITY OF SANFORD, FLORIDA p i PERMIT NO. DATE - THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE FOL- LOWING ELECTRICAL WORK; i I OWNER'S NAME PG(S — 4LJr1> I q5 ne C pn Ctr IP, ADDRESS OF JOB o sI ELEC. CONTR. u nC 1 Residential Non-residentiaLLyl— Subject to rules and regulations of the city and national electric codes. Number AMOUNT Alteration Addition Repair I l Change of Service Residential s Commercial I I Mobile Home I I Factory Built Housing0 9 iNew Residential 0-100 Amp Service 101- 200 Am Service I 201 Amp and above I New Commercial Amp Service Application. Fee I TOTAL signing this application lam st ting 1 will be in compliance with the NEC including Article 110. Section 110 9 and 110-10. Building Official MasterElectrician STATE COMPETENCY NO. CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE #: 407-322-4952 DATE: PERMIT BUSINESS NAME: Se4,[-5 A o tr f- ADDRESS:Sct-,.. o an L10 ..-:tL- (' PHONE NUMBER: PLANS REVIEW IN\ TENT PERMIT BURN PERMIT REINSPECTION TANK PERMIT FIRE SYSTEM AMOUNT $ Z 18 COMMENTS: y, % Z -5-C4 I-- '-, Fees must be paid to Sanford Building Department, 300 N. Park Avenue, Sanford, Florida. Phone # 330-5656. Proof of payment must be made to Sanford Fire Prevention before any further services can take place. V Sanford Fire Prevention I certify that the above information is true and correct and that I will ! comply with all applicable I codes and ordinances of the !p City of Sanford, Florida. A -ants S aature 9 CITY OF SANFORD.' FLORIDA PERMIT NO. -DATE- THE UNDERSIGNED HEREBY APPLIES FOR _A PERMIT TO INSTALL THE FOL. LOWING ELECTRICAL WORK; OWNER'S NAME eCt 0 lOC' zp CVon+y- U - ADDRESS OF JOB OLAJn ELEC. CONTR.I • , I C LAG} 1CCc Residential Non-residen+ia Subject to rules and regulations of the city and national electriccodes. Number AMOUNT Alteration Addition Repair CFO Change of Service. Residential'_ Commercial Mobile Home Factory Built Housing New Residential -0-100 Amp Service 1 0,rl -200"Amp Service 201 Am' and above New . Commercial Amp 5ervice Sign, I. 10 TOTAL I I v Building Official Master Electrician STATE COMPETENCY- N0.6 CITY OF SANFORD FIRE.DEPARTMENT FEES FOR SERVICES PHONE #: 407-322-4952 DATE: 3 /Z/ PERMIT #: BUSINESS ADDRESS: PHONE NUMBER:( PLANS REVIEW TENT PERMIT BURN PERMIT REINSPECTION TANK PERMIT FIRE SYSTEM AMOUNT $ 2 . C7 COMMENTS /'r `/7/ rtr /. i'YlD`l(or,-. s CCA- %119L' Fees must be paid to Sanford Building Department, 300 N. Park Avenue, Sanford, Florida Phone # 330-5656. Proof of payment must be made to Sanford Fire Prevention before any further services can take place. I certify that the above information is true and correct and that I will comply with all applicable codes and ordinances of the City of Sanford, Florida. Sa f rd ire Prevention AppliEants Signature CITY OF SANFORD, FLORIDA PERMIT NO. "I ` DATE o 3-o9-9,f THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE FOL- LOWING ELECTRICAL WORK; SLrA*3 Awro CENTER OWNER'S NAME SEARS ROE 13"C-K and CO-9AWY gsld 'To w^ c Cent'-uk C; ADDRESS OF JOB SEE )q19<it_MC1> 1-FCsaL• ESC:Zs3'leoed FIRIF ALARM ELEC) CONTR Cori PL E TC Pgb'r E cl*011 Residential Non-residentiaL_ ALAX1413, :rriC- Subject to rules and regulations of the city and national electric codes. Number AMOUNT Alteration Addition Repair Change of Service Residential I Commercial Mobile Home I Factory Built Housing New Residential 0-100 Amp Service 101-200 Arnp Service 201 Amp and above New Commercial Amp Service Applicatipn Fee100011 I TOTAL I By signing this application I am stating I will be in compliance with the NEC including Article 110, Section 110-9 and 110 10. L Building Official esfer Electrician STATE COMPETENCY NO.I:Fe000lL9 CITY OF SANFORD FIRE -DEPARTMENT FEES FOR SERY ES ` © JPHONE #: 4d7-322-4952 DATE: % - Z 3 - S PERMIT #: BUSINESS NAME: o 60--;5 Y tk--- ADDRESS: o PHONE NUMBER:( ) PLANS REVIEW TENT PERMIT BURN PERMIT REINSPECTION TANK PERMIT FIRE SYSTEM AMOUNT COMMENTS: 5 [ Fees must be paid to Sanford Building Department,,300 N. Park Avenue, Sallford, Florida. Phone # 330-5656. Proof of payment must be made to Sanford Fire Prevention before any further services can take place. 3 3 W Sa ford Fire Prevention I certify that the above information is true and correct and that I will comply with all applicable codes and ordinances of the City of Sanford, Florida. applicants Sgnathire UlTY Ul" SANr'URD, YLUXiVA APPLICATION FOR BUILDING PERMIT PERMIT ADDRESS jJr." 17 PERMIT NUMBER f A P-eV,0wS 44,64 } "o r• Total Contract Price of Job Total Sq. ,Ft. J Spf1 Describe Work S Type of Construction Flood Prone (YES) NO) Number of Stories Number of Dwellings //je} Zoning Occupancy: Residential Commercial Industrial 16, G 4 C a 3 O E x Q z rl H Z w a 0 u o fro U a J u a 0 0: , Z w F LEGAL DESCRIPTION (please attach printout from Seminole County) TAX I.D. NUMBER OWNER _ ADDRESS CITY LL TITLE HOLDER (IF OTHER THAN OWNER) ADDRESS CITY STATE BONDING COMPANY ADDRESS CITY ;STATE PHONE NUMBER ZIP ZIP ARCHITECT % t? fS t4,1ey l4f' t P '( Uf LDa ADDRESS CITY STATE ZIP MORTGAGE LENDER ADDRESS CITY STATE ZIP CONTRACTOR ( r PHONE NUMBER #d-7 331 7V& ADDRESS ST. LICENSE NUMBER CITY jnJ STATE 1 ZIP 32751) Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction., I understand that -a separate permit must be secured for ELECTRICAL, PLUMBING, MECHANICAL,- SIGNS, POOLS, ETC. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN ISSUED. FAILURE TO RECORD A NOTICE OF'COMMENCEMENT MAY RESULT IN YOU PAYING'TWICE FOR THE IMPROVEMENTS. TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH I YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits,required from other governmental entities such as water management districts,' state agencies, or federal agencies. ACCEPTANCE OF PERMIT IS VERIFICATION THAT I WILL NOTIFY THE OWNER OF THE PROPERTY OF THE REQUIREMENTS OF FLORIDA LIEN LAW, FS713. C N O O EY r+ cD v, a1 o n Signature of Owner/Agent & Date gna re o Contractor & Date o0 a trial. H Z1C Type or Print Owner/Agent Name Typ or in n ctor's Name d x 3 I (D o E ro 0 n Signature of Notary & Date Si na of Notary & Date P 0 Official Seal) (Off' al S 1 CARTER t My Commission CC353520 Expires Mw. 07,19M 0 Bonded by ANB s`oFFld°' S00 852-5878 b O p. G. Application Approved BY: Date: n FEES: Building Q Radon Police Fire ,v C/ rt Open Space,' Road Impact ;Appli ation- PERMIT VALIDATION: CHECK CASH DATE q ^ B Y o ( • ORIGINAL (BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFICE) GOLD (CO. ADMIN-) THIS_APPLICATION USED rFOR ,_WORK _,VALUED $2500.00J ORaMORE/