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<br />OWNBR' S NAMB-~";) b h <br />JOB SITB ADDRIISS G::, I O~ <br /> <br />CITY or zapSYRHILLS PBRHiT APPLICATION <br />BUILDINa DBPART~ 533! 8~ STRBwr ZBPBTR.ILLB. FL 3is40 <br />PhoneI813-780-0020 FaxI813-780-0021' <br />bAT. RBCIIXVlID, <br />I'LARS RBVllIIf n. , <br /> <br />CoI~ <br />(l~ <br /> <br />~ <br /> <br />~-+- <br /> <br />PHONB CONTACT <br /> <br />~ <br /> <br />LBGAL DBSCRIPTION. LOT (B) <br /> <br />PARCBL ID # <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSBD: oNBW CONSTRUCTION <br /> <br />-fj:ALTBRATIOH <br /> <br />o RIPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o ADDITIOt{ <br />o MOVR <br /> <br />(OBTAIN FROM PROPBRTY TAX NOTICR) <br /> <br />PROPOSBD uSRd:tSGL FAMiLY DWBLLING. OMULTI-FAMILY <br /> <br />o DBMOLISH <br /> <br />o COMMBRCIAL <br /> <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMIN(J PboL <br /> <br />o MOBILB HOMB <br />D OTHRR <br /> <br />O'RRSTAURANT & HBALTH DBPAaTMBNT APPROVAL <br />I/IBClUP'rIOH op "ORk ,.J)1. A '~6 :2:::;y;:: - S~7? s --bh <br />BUILDING SIZR dl.( SQUARI FOOTAGB HBIGHT <br /> <br />RBSIDENTIAL: <br />COMMBRCIAL: <br /> <br />~TTACH (~) J?LOT PLANS & (.:a) .SIiTS OF BUILDING PLANS & (1) SIT BNERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPRRTY SURVEY RIQUIRED FOR ALL HBW CONSTRUCTION. <br /> <br />o BUILDI~G <br />o BLBCTRICAL <br />o PLUMBING <br /> <br />. <br /> <br />RBRIIITS RBaUJiSTBj2 <br />Qltoo . cP VALOATIOH OP TOTAL """STRUCTrou <br /> <br />AMP SIIRvIes <br /> <br />o FLORIDA pOWBR <br /> <br />o ".R.E.C. <br /> <br />o MECHANICAL $ <br />o """ ,f(800PlHG . 0 SPRCDu.TY <br />TYPI! OF CONSTRUCTION I D' BLQCI{ <br />FINISHBD FLQOR ELIIVATIONS <br /> <br />VALUATION OF MIilCHANCIAL INSTALLATION <br /> <br />o OTHJlR <br /> <br />o FRAME <br /> <br />..e-sTBBL <br /> <br />o OTHSR <br /> <br />IS PROJBCT IN FLOoD ZONB ARRAo YBS J2fB0 <br /> <br /> <br />BUXLD8R <br /> <br />8L8CTRXC.IU <br /> <br />~..********.********.***************.*******.***.******..*******.. <br /> <br />COMPANY <br />STATB CBRT'OR RBQIST . <br />CITY PROCESSING * <br /> <br />SIGNATURB, <br /> <br />SIGNATURill <br /> <br />" <br /> <br />COMPANY <br />STATE CERT'OR RRGIST # <br />CITY PROC.SSING # <br /> <br />PLUllBB. <br /> <br />**.*****.A....**************.***.***..*.****************.*.....*.. <br /> <br />. IIBCRAIIICAL' <br /> <br />******.....**~********A*.*************.**********.**************** <br /> <br />COMPANY' <br />STATB CBRTOR."GIST # <br />CITYPROGBSSIHG #' , <br /> <br />SIGNATURB <br /> <br />~'l88a, " .. COMPANY . <br />\" . ~ · ~ ~ J. ~ STATR CRRT OR ltBGrBT . ~o, ~ J <br />sr"""TllRR - ~.. -. -'.'if/>' crTY PRocRs.Sl:NG . ~ . <br /> <br />.......... ............................ ......................... <br /> <br />*****************************.*****.*****.*.*******.*****.******* <br /> <br />COMPANY <br />STATB CSRT OR ~GIST. # <br />CITY PROCESSING # <br /> <br />SIGNATURB <br /> <br />~ <br />