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<br />I OWNER I S NAME Chvc/< <br />JOB BITEl ADDRESS 35() <( <br />LEGAL DElSCRIPTION, LOT(S) <br /> <br />CITY OF ZEPaYRHILL8 PERMIT APPLICATION <br />BUILUIN(~ DBPARTMBNT 5335 Sth STRlIlBl'f ZBPHYRHILLB, PL 33UO <br />Phon6IS13-'180-0020 FaxISl.3-780-00n D II {l "J <br />DATB RIOBIVBD _~::::"-.f'~~, <br />PLANS RIVIBK ... <br /> <br />Stt (11rt 'i <br />1y)J~6iie dY, <br /> <br />PHONS CONTACT <br /> <br />(f n--~d ;:6/ ~-t J <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br /> <br />- i <br />D ADDITION <br /> <br />o <br /> <br />(OB'I'AIN ll'ROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSBlDI [JNEW CONSTRUCTION <br /> <br />[JALTI:llRATION <br /> <br />o REPAIR <br /> <br />o INSTAl,l~ <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLI8H <br /> <br />PROPOSED USEr DeGL FAMILY DWELLING <br /> <br />o COMMERCIAl, <br /> <br />OMlJLTI -F'AMILY <br />o INDUSTRIAL <br /> <br />0# OF UNI're <br /> <br />[] MOBILE HOME <br />DOTnER <br /> <br />o SWIMMING POOlJ <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMSN'r APPROVAL <br /> <br />- p~ ~cW <br /> <br />S-e --=t- ~ <br /> <br />FOOTAGE <br /> <br />BUILDING SIZE <br /> <br />SQUARE <br /> <br />HEImlT <br /> <br />RESIDENTIAL: <br />COMMElRCIALI <br /> <br />A'l'TACH (2) PLOT PLANS & (2) SE'fS OF BUIl,DING PLAN'S & (1.) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUn,DING PLANS & (1.) SI!IT ENIlIRGY FORMS. <br />PROPIlIRTY SURVEY RIlIQUIRIlID FOR ALl, NEW CONSTRUCTION. <br /> <br />~BRMITS RBaU~STBD <br /> <br />[] BtJIUlING <br /> <br />$ <br /> <br />VALUATION OF TO'rAl, CC)NS'1'RUCTION <br /> <br />[] El,EC'l'RICAL <br /> <br />AMP SERVICE <br /> <br />o FI,ORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />[1 PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VAr~UATION OF MECHANCIAIJ INSTAr.I,ATION <br /> <br />[] GAS <br /> <br />o ROOF INC1 <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />'l'YPE OF CONSTRUC'1'lON I 11 BLOCK <br /> <br />o FRAME <br /> <br />D S'l'EIlIIJ <br /> <br />o O'rHER <br /> <br />FINISHED FLQOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE ARIilAO YES Cl NO <br /> <br /> <br />BUILDBR <br /> <br />COMPANY ~ QOue-- flU! <br />STATE CERT OR RIlICHST # n I H e(!)OO 3(:. <br />CI'1'Y PROCESSING # ~t' 2r <br /> <br />BIGNA'ruREl)( &# ('~, <br />I <br /> <br />************************ **************************************** <br /> <br />JlLICTRIOIAN <br /> <br /> <br />****************************************************************** <br /> <br />COMPANYu::'lpbl~ EAJf&rpr/sC'.5 "'---._ <br />STATE CER'r OR REGIS'}' # €{2i)OOO$-" t. <br />CITY PROCESSING # i'l[l{ <br /> <br />~4~ <br /> <br />S WNA'l'tJRI!I <br /> <br />PLUMBIR <br /> <br />COMPANY SLu..-.. ac/~ JCV <br />STATE CERT OR REGIST # {)/ J..I <br />CI'l'Y PROCESSING # :30.0 g- <br /> <br />~----, <br /> <br />8IGNA'l'URE'T IJH ~. <br />.********************** <br /> <br />()()CJO I'rc <br /> <br />SIGNATURE <br /> <br /> <br />MBCHANICAL <br /> <br />***************************************************************** <br /> <br />OTHBlR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />S WNATURE <br /> <br />***************************************************************** <br />