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<br />(.;.1.'1~. ;",ii.i' i""J!H~L,_,~dL.L.'] l?J:'.L_,_".'.1' AJ!PLICAT.IOI'oJ <br />BUILDING nBPARTKBNT 5335 Sth STRBBT ZKPHYRHILLS, FL 33540 <br />Phone.813-780-0020 FaxI813-7S0-0021' <br />DATB RBCBIVlID <br />PLANS R:IIVIBIf JlBB . <br /> <br />OWNER'S NAME (Y1AljoliG tKJu,vd <br />,JOB srrE ADDRBSS 3~(p ICf ..J-v" I~O 5' !J.fle <br />LEGAl. DESCRIPTION I LOT(S) BLOCK <br /> <br />PHONE CONTACT ~ ....? ~~ -/~ 3:; <br />I . 1 <br />,"- ~/1.s/"2f i lie. <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # O~- ~(p..:;l'l -t:::Ja/(J - o~ 100.-0000 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />DADDITIO~ <br /> <br />DALTERATION <br /> <br />D REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE:~SGL FAMILY DWELLING <br />[J COMMBRCIAL <br /> <br />[JMULTI-FAMILY <br /> <br />0# OJ? UNITS <br /> <br />o MOBILE HOMb: <br />o OTHER <br /> <br />[J INDUSTRIAL <br /> <br />o SWU1MING POOL <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIP'rION OF WORK f-e-lZc::Jt!J ~ <br /> <br />.sl^'rJ/~ pl,,/ ~6t"~ ~64YA~~ <br />I ' <br />SQUARE FOOTAGB ~ 3 l HEIGHT <br /> <br />BUILDING SIZE <br /> <br />RBSIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING 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 />PERMITS REQU.~TED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />38'71 <br /> <br />00 <br />---.. <br /> <br />VALUATION OF 'rOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />o PI,UMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />VROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FI...oOD ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDBR <br /> <br />COMPANYd I) LI : )'\ ~ t' b Ie. A s; 5 () L <br />STATE CER'J' OR R~GIST # C c c. 0 L( 9 3 b 7 <br />CITY PROCESSING 4# -3 0 ~ <br /> <br />SIGNATURE <br /> <br />***********.......**..*........................................... <br /> <br />BLBCTRICIAN <br /> <br />SIGNA'I'URE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />*.*....**.*..*.*..*.*.*.*.**.*...*****.**********.**..***.***.**.* <br /> <br />PLUHBBR <br /> <br />COMPANY <br />STATE CERT OR RRGIST # <br />CITY PROCESSING # ' <br /> <br />SIGNATURE <br /> <br />NBCHAHICAL <br /> <br />**..**..**..*..**..***************.**..**********..*********.***.. <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />*****..****************..***.***.***********.****.*************** ' I <br /> <br />OTHBR fl.-n('j.pC'~J <br />Slc:JNA'!'URIil __.~ 'fV1 -G.J~ <br /> <br />COMPANY -s.-,J1/fp~Ahlt!. ~<S::r~~ <br />STATE CERT OR REGIST # ~~~~ <br />CITY PROCESSING # <br /> <br />********************************.*********.******t,*.************* <br />