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<br />OWNBR'S NAM~ -~'J,;JOtrJ IJ"Ot...d '(r:.Me.f/. Gc...r,y <br />JOB 9ITB ADDRBSS .3 ?S''7S-' ~~~ .c...Or~hO( o..u€ <br /> <br />CITY or ZBPSYRHILLS PERMIT APPLICATION <br />BUILDIHa DBPARTMBHT 5335 8~ S'l'RBBT ZBPBTR8XLLS. FL lis40 <br />Phon.1813-780-0020 .axI813-780-0021' <br />bATH UCIIXVlID, <br />PLUS RDllIIf .... , <br /> <br />4 <br /> <br />PHONB CONTACT <br /> <br />i <br /> <br />LEGAL DESCRIPTION. LOT(S) <br /> <br />PARCBL ID ft <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSBD: (JNBW CONSTRUCTION <br /> <br />oADDITIOt{ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICB) <br />~LTBRATION 0 REPAIR 0 INSTALL <br /> <br />DSIGN (J MOVIil (J DIilMOLISH <br />PROPOSBD USEr~GL FAMiLY DWELLING OMULTI-FAMILY 0# OF UNITS <br /> <br />o COMMBRCIAL <br /> <br />o INDUSTRIJ\.L <br />, <br /> <br />[] SWIMMING. P60L <br /> <br />o MOBILB HOMB <br />D OTHBR <br /> <br />o RESTAURANT & <br />. ~ESCRIPTION OF WORK ~'e.k ..C' <br />~ K s-s- <br /> <br />HBALTH DBPARTMENT APPROVAL <br /> <br />(,U,14 ~~ ~O(V-ht-U' rk..I'> .2.. Tc...t2 SJ.,.";/~--i <br />SQUARE FOOTAGB /~ ~~ F-f HBIGHT ~ 1=1 <br /> <br />BUILDING SIZB <br /> <br />RBSIDBNTIALr <br />COMMERCIAL: <br /> <br />~TTACH (2) Ji'LOT PLANS & (.:a) ,SliTS OF BUILDING PLANS & (1) SET BNERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRIilD FOR ALL NBW CONSTRUCTIQN. <br /> <br />o BUILDI~G <br />. 0 BLBCTRICAL <br /> <br />'6) <br />t) <br />~ PBRIIITS RBaUJifilTBD <br />'~ VALUATION OF TOTAL CONSTRUCTION <br /> <br />. <br /> <br />AMP SBRVIes <br /> <br />o FLORIDA POWBR <br /> <br />o ".R.E.C. <br /> <br />o PLUMBING <br /> <br />o MECHANICAL $ <br />o GAS ~FlNG. 0 SPECIALTY' <br />TYP]J OF CONSTRUCTION I D. BLqCI{ <br /> <br />VALUATION OF MBCHAilCIAL INSTALLATION <br /> <br />o OTHBR <br /> <br />o FRAME <br /> <br />J!1" STBEL, 0 OTHER <br />Is PROJBCT IN FLOOD ZONE ARBAo YBS ~O <br /> <br />FINISHBD FLQOR RLBVATIONS <br /> <br /> <br />BUXLDHR <br /> <br />COMPANY <br />STATB CBRT,OR RIIQIST # <br />CITY PROCESSING * <br /> <br />SIGNATURB, <br /> <br />8LBCTRl:C.IU <br /> <br />~**********.************************************.******..********* <br /> <br />SIGNATURill <br /> <br />.0,. <br /> <br />COMPANY <br />STATE CBRT'OR RBGIST # <br />CITY PROc.aSING # <br /> <br />PLUllBB. <br /> <br />*********A**.*******************************~********************* <br /> <br />COMPANY' <br />STATB CBRT OR!"GIST # <br />CITYPROGBSSING #. . <br /> <br />SIGNATtJRB <br /> <br />IIBCIlAlfICAL' <br /> <br />*************~********A******************************************* <br /> <br />COMPANY <br />STATB CBRT OR ~IST. # <br />CITY PROCBSSING # <br /> <br />SIGNATURB <br /> <br />t.OTRD, " COMPANY . <br />~ .. / ~ ..~ - STATB CRT OR RBGIST # ~ 9 \' I <br />SIOHATURB -~~,(17--1 , J 61 / J _ CITY PR"""SSINO . ' I <br /> <br />......... .:..................................................... <br /> <br />***************************************************************** <br /> <br />~ <br />