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<br />OWNER'S NAMB p; 'f!l. !l-e <br /> <br />CITY OF ZEPgYRHILLS PBRMIT APPLICATION <br />BUILDING DBPART~ 5335 8~ STRBBT ZBPRTRB.ILLS, PL 33540 <br />Phone.813-780-0020 Pax.813-780-0021. LI O_/'J V) <br />DATB .BCB:IVBD . r - L V "- <br />PLANS RBVIIIIf rBII . <br /> <br />,~1 /4 ~ <br /> <br />(J / 't -I -/.~ <br />i I +-.0- A iJfvvu~ <br /> <br />JOB SITE ADDRESS <br /> <br />PHONE CONTACT <br /> <br />LEGAL DESCRIPTION. LOT(S) <br /> <br />BLOCK <br /> <br />PARCBL ID # <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPBRTY TAX NOTICE) <br /> <br />o ADDITIO~ <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSI<JN <br />PROPOSED USE: ~ FAMI~Y DWELLING <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI - FAMILY <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />PESCRIPTION OF WORK <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />SeWf'tL Lr'..ve.- <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 BNERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PBRNITS RBaUa~TBD <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELBCTRICAL <br />~MBING <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <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 BLQCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLQOR ELEVATIONS <br /> <br />IS PROJBCT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDBR <br /> <br />SIGNATURB. <br /> <br />COMPANY <br />STATE CBRT.OR REGIST # <br />CITY PROCESSING # <br /> <br />BLBCTR.IC.IAH <br /> <br />~**********A****************************************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERTOR REGIST # <br />CITY PROCESSING # <br /> <br />PLUJlBBR <br /> <br />****************************************************************** <br /> <br />?lu~'~J <br /> <br />~ ~l <br />, " <br /> <br />SIGNATURE <br /> <br />/~e <br /> <br />COMPANy. (r4/;J~ S~1y 5 <br />STATE CERT ORR GIST # <br />CITY PROCESSING # <br /> <br />IOICIIAHICAL. <br /> <br />****************************************************************** <br /> <br />COMPANY <br />STATB CERT OR RBGIST. # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHBR <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***************************************************************** <br />