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<br />CITY OF ZBPHYRHILLS PERMIT APPLICATION <br /> <br />BUILDING DBPARTMBNT 5335 Sth STRBBT ZBPBTRB:ILLS. I'L 33540 <br />PhoneIS13-780-0020 l'axI813-780-0021' <br />DATB ilJICBJ:VlID <br />PLUS RBVXBtf I'BB . <br /> <br />OWNER' S NAMB(,)~",,.t;; ~ Pt'rl]~ ,(" ~S' sl ~ ~ <br />JOB SITE ADDRESS 37 ->l o Lap.. ~ 1'Jp, !r0... <br /> <br />PHONE CONTACT <br /> <br />SUBDIVISION &1A~ 0 M-6LJ'Z..~ ~ P.4,&E ~ <br /> <br />LEGAL DESCRIPTION. LOT(S) ('3 S <br />PARCEL ID # <br /> <br />BLOCK <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />DADDITIO~ <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />o MULT I - FAMILY <br /> <br />0# OF UNITS <br />D SWIMMING mOL <br /> <br />D MOBILE HOME <br />o OTHER <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />~ .' <br />I?ESCRIPTION OF WORK ~'tM..A. 1:1 R€',B~~'.S( v>v.abl.lI.J'.J" >t24Z ~~/ ~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />~TTACH (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 />PBRMITS REQU8STBD <br /> <br />Ip.-BUILDING <br /> <br />$ 6Lr.f"g.. 00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />D PLUMBING <br /> <br />D MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D GAS <br /> <br />D ROOFING . D SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLqCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLQOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA DYES D NO <br /> <br />:_.1 :,: ,,:,' , ',' ,': :, C'. I , : I ,".', ~ _ . ,:' ""~":"~."<\.': <br /> <br />BUILDBll <br /> <br />SIGNATURE. ~B : <br />. .t?- <br /> <br />-- <br /> <br />COMPANY /( "Y'L--A 1~'S~,hUz~ ~ e:.- <br />STATE CERT. OR REGIST # CRe 0.:>-8 $"6e <br />CITY PROCESSING # c:t C( I Lf. <br /> <br />************************************.******************.**.******* <br /> <br />BLBC'l'R.ICIAH <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERTOR REGIST # <br />CITY PROCESSING # <br /> <br />**.*.*********.******.******************************************** <br /> <br />PLUMBBR <br /> <br />COMPANY <br />STATE CERT OR,R8GIST # <br />CITY PROCESSING # . <br /> <br />'>.", SIGNATURE <br /> <br />IIBCRAHlCAL' <br /> <br />**.**********~**************.*********************.*************** <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />************************************************...*......****..* <br /> <br />O'l'BBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />..*.*****.******..*********************************************** <br />