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<br />OWNBR'S NAM~ --:\)~'n~ . t~~ <br />JOB SITB ADDRIISS ~~ a ~ L.. ~";)<..ot:.~~ "~~ <br /> <br />CITY or zapSYRHILLS PBRHiT APPLICATION <br />BUILDINa DBPAR~ 53]! 8~ STRBWr ZHPRYR.XLLS. FL lis40 <br />PhoneI813-780-0020 FaxI813-780-0021' <br />bA'l'a ..aCIIXVllD, <br />I'LJUfS RBV':nnr .... . <br /> <br />LBGAL DBSCRIPTION. LOT(S) <br /> <br />pHONR CONTACT <br /> <br />- rnlNfJ{)1 <br /> <br />PARCBL ID ft <br /> <br />BLOCK <br /> <br />\ 2- - 2.~ - 2..... \ <br /> <br />SUBDIVISION <br /> <br />DSI(JN <br /> <br />- aoSa ~~ ~ (OBTAIN FROM PROPERTY TAX NOTICR) <br />~\'-O <br />la)AnDITIOt{ o ALTBRAT ION 0 RIilPAIR 0 INSTALL <br /> <br />WORK pROPSED: oNEW CONSTRUCTION <br /> <br />DMOVIil <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE r DSGL FAMiLY DWELLING <br /> <br />oMULTI - FAMILY <br /> <br />0# OF UNITS <br />o SWIMMIN<<J pboL <br /> <br />o MOBILB HOMB <br />D OTHRR <br /> <br />OCOMMBRCIAL <br /> <br />o INDUSTRIJ\.L <br />, <br /> <br />BUILDING SIZR 1'1.)< <br /> <br />CJ RRSTAURANT & HRALTH DBPAaTMBNT APPROVAL <br />~,M.~~a ~GM <br />-- SQUARE FOOTAGR "2-1(., ~ <br /> <br />~ESCRIPTION OF WORK <br /> <br />RRSIDRNTIALr <br />COMMIilRCIAL. <br /> <br />~TTACH (~) J?LOT PLANS & (.:I) .SIiTS OF BUILDING PLANS & (1) SRT ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET RNERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NBW CONSTRUCTION. <br /> <br />HBIGHT <br /> <br />'}:liI BUILDI~G" <br />D RLRCTRICAL <br />o PLUMBING <br /> <br />. 4139 <br /> <br />(.)0 <br /> <br />RBRIIITS RBaUJifilTBD <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SRRvles <br /> <br />o FLORIDA POWBR <br /> <br />o ".R.B.C. <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFlNG <br /> <br />D SPBCIALTY <br /> <br />VALUATION OF MBCHANCIAL INSTALLATION <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION r D" BLQCI{ <br />FINISHRD FLOOR ELRVATIONS <br /> <br />D FRAME <br /> <br />o STRRL <br /> <br />o OTHRR <br /> <br />IS PROJBCT IN FLOOD ZONE ARBAo YBS 0 NO <br /> <br /> <br />BUXLDa. <br /> <br />IILIICTilxc.IU <br /> <br />~**********.**********.********.*****.***..**..*.****.****.*****.* <br /> <br />COMPANY-:SU~ ~ <br />STATE CIIRT. OR RJI(]IST ft--;fr <br />"CITY PROCBSSING *. (:J- <br /> <br />SIGNATURB. <br /> <br />SIGNATURE <br /> <br />"0,. <br /> <br />COMPANY <br />STATB CBRT"OR REGIST # <br />CITY PROC.SSING # <br /> <br />PLUllBB. <br /> <br />*..******A*....****.**..***************.****.*****.*.************* <br /> <br />COMPANY' <br />STATB CBRT OR!RJGIST ft <br />CITYPROGJllBSING #. . <br /> <br />SIGNATURB <br /> <br />IIBCRAIIICAL' <br /> <br />*************~********A***************************************.*** <br /> <br />COMPANY <br />STATE CRRT OR ~GIST. # <br />CITY PROCBSSING # <br /> <br />SIGNATURB <br /> <br />0'1'.11. . <br /> <br />***************************************************************** <br /> <br />SIQNATURB <br /> <br />**.***~..*.*******..********************.*****************.******* <br /> <br />COMPANY <br />STATB CRRT OR REGIST # <br />CITY PROCESSING 4#-.:." <br />