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<br />OWNBR'S NAMB <br /> <br />CITY or ZmpSYRHILLS PERMIT APPLICATION <br />BUILDIHQ nBPARTKBHT 633! 8~ STa"T ZHPRYRRILLS. FL 33840 <br />>>hone.I.3-7ID-DD2D >>Ox.I.3-710-002.- _ //_ ~7'- ~ <br />bATH llRcBJ:VlID, 7 - eX' 0 ~ <br />PLARS aBYI'" ...a , <br /> <br />JOB SITB AnnRBSS <br /> <br /> <br />PHONB CONTACT <br /> <br />LBGAL DBSCRIPTION. LOT(S) <br /> <br />PARCBL ID # <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSBD: ONBN CONSTRUCTION <br /> <br />(OBTAIN FROM PROPBRTY TAX NOTICR) <br /> <br />Osnnt <br /> <br />o ADDITIO~ <br />o MOVR <br /> <br />o ALTlRAT ION <br /> <br />o RBPAIR <br /> <br />o INSTALL <br /> <br />PROPOSBD USR: OSGL FAMj~y DWRLLING. DMULTI-FAMILY <br /> <br />o DEMOLISH <br /> <br />[] COMMIIRC~AL <br /> <br />o INDUSTRIAL <br />, <br /> <br />0# OF UNITS <br />o SWIMMING. PbOL <br /> <br />o MoBILI HOMB <br />o OTHBR <br /> <br />,QBSCRIPTION OF WORK <br /> <br />CJ 'RBSTAtJRANT " HHALTH DBPAaTMBNT APPROVAL <br /> <br />SQUARB FOOTAGR <br /> <br />BUILDING SIZR <br /> <br />RBSIDBNTIAL: <br />COMMIRCIALr <br /> <br />~TTACH (J ) PLOT PLANS & (,;a), SETS OF BUILDING PLANS Ii (1) SBT aNBRGY FORMS. <br />ATTACH (3) SBTS OF BUILDING PLANS & (1) SBT INaRGY PaRMS. <br />PROPBRTY SURVEY RBQUIRBD FOR ALL NBW CONSTRUCTIQN. <br /> <br />HEIGHT <br /> <br />[] BUILDI~G <br />[] BLBCTRICAL <br /> <br />PBRIlITS RBOU.'TBD <br /> <br />$ <br /> <br />VAi.UATION OF TOTAL CONSTRUCTION <br /> <br />AMP SIIRVICB <br /> <br />[] FLORIDA POWBR <br /> <br />o ".R.B.c. <br /> <br />[] PLUMBING <br /> <br />[] MBOHANICAL <br /> <br />$ <br /> <br />VALUATION OF MBCHAifCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />o ROOP'J,NG ,[] SPECIALTY, [] OTHBR <br /> <br />TYPB OF CONSTRUCTIO>> r [], BI,QCK <br /> <br />[] FRAMB <br /> <br />[] STaaL <br /> <br />[] OTHBR <br /> <br />FINISHBD FLQOR BLBVATIONS <br /> <br />IS PROJBCT IN FLOoD ZONa AR:llAO YBs [] NO <br /> <br /> <br />BUILnHa <br /> <br />8LBCTRJ:CJ:AH , COMPANY FEE t: ~~ '-- <br />I V" , ' '.. ' ~k, ~., {) STATB, CBRT ',0, R RBGIST # E R.OQOY<OYt) <br />SIOIIATURli _L'l~ u-V-- ~ CITY PROC~SS_. [0<., <br /> <br />.................................................................. <br /> <br />~................................................................. <br /> <br />CO~PANY <br />STATB CBRT'OR RBGIST # <br />CITY PROCESSING # <br /> <br />BIGNATURIlI <br /> <br />PLUllBBR <br /> <br />, IIBCIlAlfICAL' <br /> <br />.................................................................. <br /> <br />COMPANY , <br />STATB caRT OR,~GIST # <br />CITYPROCBSBI~G #' .. <br /> <br />SIGNATtmB <br /> <br />COMPANY. <br />STATB CBRT OR ~IST. # <br />CITY PROCBSSING # <br /> <br />SIGNATURB <br /> <br />OTRa.. , <br /> <br />................................................................. <br /> <br />SIGNATtJRB <br /> <br />...............................*...........*..................*.. <br /> <br />COMPANY <br />STATE CBRT OR RBGIST # <br />CITY PROCBSSING # <br />