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<br />c&~J (;2 - S-~ ( I.3t-- <br /> <br />APPLICATION FOR PEmaT <br />CITY 01' ZEPHYlUIILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED Il-;( q--- 'of <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME C!.Jt<)~ ot ~~~"'5; Ck#'\.(S"J <br />- <br /> <br />JOB ADDRESS Yo'? ~ ~ I fe,ti1 ~ <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />~'S -2-S"' -"'2., -00/0-06'4-00 -OQI () (OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: oNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />IBSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: oSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br /> <br />BUILDING SIZE <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />f'l..A1i0' uE CXtc;.:i' "'.S .-f~~'ITa'" 01 Loo1.S ~ j ~ 8 IN ~Tct / ( N..f4J <br />"?__;h ?/ <br />SQUARE FOOTAGE ~ HEIGHT __ <br /> <br />~THER _ I <br />OJ,, tI~ <br /> <br />DESCRIPTION OF WORK <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 />PERMITS REQUESTED <br /> <br />~ILDING <br />~ECTRICAL <br /> <br />$ <br /> <br />cJv <br />f)~Od -- <br /> <br />~ AMP SERVICE 0 FLORIDA POWER <br />Ho"~ v/'J -io e~rS7In:5 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />" g5'*! <br />'3~?- ..// <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY JU..p, 5 e:JS I .5 J-t - <br />STATE CERT OR REGI ST # cJ 4lJc)cJ/" r <br />CITY PROCESSING ~ ~ ~1:>r' a50-r ~I!.- <br /> <br />..................................................- - ~~ <br /> <br />COMPANY~~~ SJ ~ <br />, STATE CERT 0 REG~"""'d/.J <br />CITY PROCESSING # .:;.tt.o 9 <br /> <br />*************************************************. ******** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />**********~******************************************************* <br />':~---~'~PAN'f' <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />MECHAH:ICAL <br /> <br />***************************************************************** <br /> <br />OTHBll <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />