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<br />'--CdlbfJ ~ -/y'- 0 ~ K/- j <br />CITY OJ.l' ZBPHYRHILLS PERMIT APPLICATl:ON <br />BUILDING DEPARTMBNT 5335 8~ STRBBT ZBPRTRBILLS, PL 33540 <br />Phone.813-780-0020 Pax.813.780-0021 <br />DAD RBI:!EIVBD ,.;! - (/ - O::z.. <br />PLANS R:lIVIRW PHB <br /> <br />OWNER'S NAME S/~UC:ry" _ -;-; <br />JOB SITE ADDRESS 171;20> s2ZY <br /> <br />S c.l/A~-6/<:' PHONE CONTACT <br />S-r:. 2.::::::'/'W~ .,L.-- 2::' . <br /> <br />'71 7 -r:2Y?C) <br />3..3::Y~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCBL ID # <br /> <br />WORK PROPSED: ONEW CoNSTRUCTION <br /> <br />(OBTAIN FROM ]~ROPERTY TAX NOTICB) <br /> <br />OSIGN <br /> <br />tl\J ADDITION <br />o MOVE <br /> <br />o ALTERATION <br /> <br />o RliPAIR <br /> <br />o INSTALL <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMuLTI-FAM1LY <br /> <br />0# OF UNITS <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />DESCRIPTION OF WORK <br />I'X J,/ <br />BUILDING SIZE <br /> <br />A.JJD <br />/"If )r ;)( <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />G~0C:. <br /> <br />SQUARE FOOTAGE <br /> <br />30'( <br /> <br />HBIGHT <br /> <br />g-" <br /> <br />RBStDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & ( 1)1 SET ENBRGY FORMS. <br />ATTACH ( 3 ) SETS OF BUILDING PLANS & ( 1) SET ENBRGY FORM~J. <br />PROPERTY SURVEY RBQUIRBD FOR ALL NEW CONSTRUCTION. <br /> <br />PBRMITS. RBQUBSTBD <br /> <br />o BUILDING <br /> <br />$ <br /> <br />.) C::6~ ~. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELBCTRICAL <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />DGAS <br /> <br />D ROOFING <br /> <br />D SPBCIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES. D NO <br /> <br />! " " . . '.- <br />1 I . " <br />. , , . .... I, . <br /> <br />BUl:LDBR <br /> <br />SIGNATURE <br /> <br />.Jb ?:--Y- <br /> <br />COMPANY ~r-I<::::.~ <br />STATE CERT OR REGIBT # <br />CITY PROCESSING # <br /> <br />~********.*******************************~*********.************** <br /> <br />BLBCTRl:C:IAB <br /> <br />COMPANY <br />STATE CERT OR RBGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUllBBR <br /> <br />COMPANY <br />STATB CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGN1\.TURE <br /> <br />IIBCIlAKICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />ODBIt <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />