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<br />CITY OF ZEPHYRUIIJL8 PERMI'f APPI..ICA'l'ION <br />BUILDINC1 UEPAR1'MEN'f 5335 8th STREE'f ZEPJlYRHILLS, FL 33540 <br />' . PhoneI813-780-0020 FaxI813-780-0021 .. <br />DATB RBCBIVED <br />--------.----------.. <br />~LANS RBVIBW FRB <br /> <br />, OWNER'S NAl'-1E 1.;i:};if:J..s--L~o#/~_______________________ PHONE CONTAC'~?5 -/01/7_ <br />,JOB BI'I'E ADDRESS -~Y29__dO..+_tz__5.'j~____,_.....___..._.________.____. '___ <br /> <br />LEGAL DEJSCRIP'l'ION: LOT (S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />--~----~--_.- <br /> <br />PARCEL 10 # <br /> <br />CJSIGN <br /> <br />o ADDITION o AI/rERA T ION [] REPAIR [J INSTAl,l, <br />D MOVE D DEMOLISH <br />DMlJLTI.. F'Al'1ILY D# OB' UNITS [J MOBILE II 01-1 E <br />[) INDUSTRIAL o SWU1MING POOl, [J OTHER <br /> <br />(OBTAIN F'ROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSElD: 0 NEW CONSTRUCTION <br /> <br />PROPOSED USE: OSG[, FAMII,Y DWELLING <br /> <br />o COI-1MERCIAl, <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPAR'fMEN'l' APPROVAl, <br /> <br />-~-~---------- <br /> <br />SQUARE FOOTAGE <br /> <br />BlJII,DING SIZE <br /> <br />------------ <br /> <br />REl8 IDEN'I'IAL: <br />COM~1ERCIAI., : <br /> <br />lIE!] IGHT <br /> <br />A'I"l'ACH (2) PLOT PLANS & (2) SETS OF BTJIlJDING PLANS & (1) SET ENERGY FORMS, <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMlr~REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONS'l'RUCTION <br /> <br />[] ELECTRICAL, <br /> <br />Af\1P SERVICE <br /> <br />o FLORIDA POWER <br /> <br />?J~~~ <br /> <br />[J W,R.E,C. <br /> <br />[J PI,UMB INGI <br /> <br />~CHANICAL <br /> <br />$ <br /> <br />3-100. ~ <br />, <br /> <br />--- VALUATION OF /VIECHANCIAL H1STAU,AT IOn <br /> <br />[] (3AS <br /> <br />LJ ROOF ING <br /> <br />[] SPECIAUry <br /> <br />[J OTHER <br /> <br />'l'YklBl OF CONSTRUCTION: [J BLOCK <br /> <br />o FRAl"IE <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FIlHSHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES <br /> <br />CI NO <br /> <br /> <br />BUlI.DIIR <br /> <br />COMPANY _______ <br />STATE] CERT OR REG 1ST # _.__________,_._._ <br />CITY PROCESSING # <br /> <br />S H3NA'I'UREJ <br /> <br />****************************************************************** <br /> <br />llILBC'l'RICIAN <br /> <br />SIGNA'I'IJRE <br /> <br />COMPANY ____,_______ <br />STATE CERT OR RECHST # <br />CITY PROCESSING # <br /> <br />._--_._-----_._-_....~_.. <br /> <br />****************************************************************** <br /> <br />PLUMBBR <br /> <br />COMPANY-__ <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNA'I'URE <br /> <br />* * * * *If'* * * * * * * * * <br />MBCHANICAI. COMPANY ",'1PJ~,'7-- <br />/~----- Q STATE CERT OR REr.HST # L4<;D 5-225:.-1 ..-= <br />SlGNJ~'l'URE L, ~) ._____. CITY PROCESSING ~ <br /> <br />********* ************************************************** <br /> <br /> <br />OTHER <br /> <br />COf\1PANY <br />STATE CERT OR REG 1ST # <br />CITY PROCESSING # <br /> <br />, SIGNATURE <br /> <br />-----.------------ <br /> <br />***************************************************************** <br /> <br />, <br />~._----_._-.__._--_._.. <br />