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<br />APPLICATION FOR PERMIT <br />CITY or Zll:PHYRHILLS <br />BUILDING DEPARTYIi:NT <br /> <br />DATE UCEIVED ~ /27 /0; <br />PLANS REVIEW I'EE <br /> <br />OWNER'S NAME C,4 rz 0 1- Y N fi4tvr E 5 <br />JOB ADDRESS 3'] (P'tZ NEu/CoIIA AvE. <br /> <br />PHONE '7t l - / V& 'I <br /> <br />La, /r;: <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # "}f-z5 - 2-1 - 09/0- Of], 00 -00 f.5 <br /> <br />SUBDIVISION &tlA/vtl f.i~ (Z( Zt>;V <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />o SIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI - FAMI L Y <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br /> <br />o OTHER <br />{2,~ ,A-rrAc. i-f <br />//Lv,vt I jl.Jv /Ill ~ <br />P A c!..Aw/.: <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK (Al2fJDtt-r I U - (l-l:>ol''^- <br /> <br />BUILDING SI ZE I!; K 4-1 <br /> <br />SQUARE FOOTAGE <br /> <br />b/!i <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~ILDING <br />~~CTRICAL <br /> <br />$ IOdX>O. 00 <br />I <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C.4//~E fHptl <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />SIGNATURE <br /> <br />~ ;J. f2j~? <br /> <br />COMPANyJ~J.l-c~r{(.(hn()f\/ f!)F ~ {:X, <br />STATE CERT OR REGIST # Ct5CO ~??rz <br />CITY PROCESSING # "2~ <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />thu~A. ~1J <br /> <br />COMPANY IJ~ Et_6::.772t( <br />STATE CERT OR REGIST # ct3co 5')?K'Z-- <br />CITY PROCESSING # Z(p <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***********~****************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />