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<br />OHNRR'. NAMR. ~.i1t 0~~c~ <br />JOB BITH ADD.....;; -3 .. ~ . .f h (, <br /> <br />CITY OF ZEPgYRHILLS PERMIT APPLICATION <br />BUILDING DHPART~ 5335 8~ ST"HT ZHPRTRRILLS. FL 33540 <br />Phon8.813-780-0020 Fax.813-780-0021' <br />DATB lUICBJ:VlID, <br />PLAKS RBVJ:JI1f "'B , <br /> <br />PHONB CONTACT 7;) - /- 5',;-5 <br /> <br />2~h f r ~,/;; <br /> <br />SUBDIVISION <br /> <br />LBGAL DBSCRIPTION. LOT(S) <br /> <br />BLOCK <br /> <br />PARCBL ID * <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPBRTY TAX NOTICE) <br /> <br />OSIGN <br /> <br />OADDITIO~ <br />o MOVE <br /> <br />~RATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE:OSGL FAMi~Y DWELLING <br />o COMMERCIAL <br /> <br />DMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />0* OF UNITS <br />o SWIMMING PdoL <br /> <br />o MOBILE HOMB <br />o OTHBR <br /> <br />QBSCRIPTION OF WORK <br /> <br />D'RESTAURANT <br />/2(f7r~rr~ <br /> <br />& HEALTH DBPARTMENT APPROVAL <br /> <br />f)(';yf- /J v~/?, <br />( ( I <br />SQUARE FOOTAGB <br /> <br />BUILDING SIZB <br /> <br />~TTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SBTS OF BUILDING PLANS & (1) SB~ ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION, <br /> <br />HBIGHT <br /> <br />RBSIDBNTIAL: <br />COMMERCIAL. <br /> <br />PBRKITS RBOU_$TBD <br /> <br />o BUILDI~G <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o BLBCTRICAL <br /> <br />AMP SIIRVICB <br /> <br />o FLORIDA POWER <br /> <br />o W,R.B,C. <br /> <br />o PLUMBING <br />~CHANICAL <br /> <br />o GAS <br /> <br />o ROOF;J:NG <br /> <br />0...2- <br />$ 1---; b?- ~ VALUATION <br /> <br />. 0 SPBCIALTY 0 OTHER <br /> <br />OF MECHANCIAL INSTALLATION <br /> <br />TYPE oir CONSTRUCTION: 0 BLQCK <br /> <br />o FRAMB <br /> <br />o STEBL <br /> <br />o OTHER <br /> <br />FINISHED FLQOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONB ARRAO YES 0 NO <br /> <br /> <br />BUILDBR <br /> <br />COMPANY <br />STATB CERT'OR REGrST * <br />CITY PROCESSING # <br /> <br />S IGNATURB. <br /> <br />BLBCrrRJ:CJ:AH <br /> <br />~..........*...................................................... <br /> <br />SIGNATURE <br /> <br />"J' <br /> <br />COMPANY <br />STATB CERTOR RBGIST * <br />CITY PROCBSSING * <br /> <br />PLUllBBR <br /> <br />.................................................................. <br /> <br />COMPANY , <br />STA~B CERT OR,RRGIST # <br />CITY ~ROCHSSING * ' <br /> <br />, " " SIGNATUlU!l <br /> <br />SIGNATURB <br /> <br />.............*........*....*................~~.........~.....!... '~/ . <br />.. '. COMPANY .0 U~""/Jv~/7 5 /Ie /:11/ v-- <br />./ ~ ~ ~...' ~~ '. . STATB CHRT OR ~GIST. # c./I.( CJ 5'f 7? I <br />r/'~*T- / {/ / ~~ CITY PROCB..ING, :J- } ( <br /> <br />................................................................. <br /> <br />IOICIIAlUCAL' <br /> <br />OTBBR . <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CBRT OR REGIST # <br />CITY PROCBSSING # <br /> <br />................................................................. <br />