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<br />CITY OF ZEPUYRH:r:IJI1S PERMI'!' APPI.1ICA'l'ION
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<br />I:lUUJDIWJ IHllPAR1'MI!lN'f 5335 8th STRlllBl'l' ZIllIi'UYRHILI,I3, FI, 3'3940
<br />PhOnEtI813-'l80-0020 Fa,cI813-780..0021
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<br />ADDRESS lh~~ h-c;~~_h~~~~'=,L~_._______.~_ _~_h__ ...._ ~__'____,_
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<br />, OWI/EJR 'S
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<br />LEGAL lJHlSl!RJP'l'IOlJl L,OT(S)
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<br />BLOCK
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<br />SUBDIVISION
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<br />PARCEll, llJ n
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<br />WORK PIWPSEJD. []NE\'l COlWTRlJC'I'ION
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<br />(OBTAIN P'Ror,] PROPERTY TAl{ N()'1'IC!I1:)
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<br />CJ ADIH'I'IOIl
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<br />[] ALTERATION
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<br />[) REPAIR
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<br />IJ I118'l'AT,I,
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<br />[J 8 lC3N
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<br />[J WJVH:
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<br />[J UHJtl]OIJISII
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<br />PROPOSHllJ !JSE. [Jsm., F'AMH,Y D\'lEL,I,JNG
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<br />[J Iv] LJ un .. F' AH I J, I'
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<br />[J# OF' UIH'I'S
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<br />1.1 t'IOB H,H] Hut.lm
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<br />[J CUI1MEJRCIAI I
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<br />n JNDUSTRIAf.,
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<br />[] SIHI-1t1INr3 poor,
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<br />[J O't'IIEJR
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<br />COM~lEIR(!IAI,: A'l"I'ACII (3) BElTS OF BUJI.IJJlm PLANS & (1) BElT ENElRGY FORl18.
<br />PRuPBJR'ry SURVEY RElQIJIRED F'OR AI,I, NEH CONSTRUCTION.
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<br />PERMI'fS REnUES'rEn
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<br />$
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<br />VAfJIJATIOH OF TOTAL, COI18'1'RUCTION
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<br />.._..._---_._-~~-_._-_.~~..-
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<br />AtlP SERVICE!
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<br />F'I,uRlfJA POHER
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<br />~I. R. E. C.
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<br />I.J !vlH1CHAIHCA L
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<br />$--.-.------.------------ VAL,tJA'l'IOH OF' !"IECHMlClAfJ IllST1\I ,r.A'l' Ion
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<br />LJ W\S
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<br />Ll ROOF ING
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<br />IJ SPElCnAUl'I'
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<br />LJ OTHER
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<br />'I'YlJlll OF COlJEl'l.'R{J(!TlON I f] BIJOCK
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<br />(] FRANEl
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<br />C] 8TEEJIJ
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<br />[J OTHER
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<br />1:1' IIH811E:1J FI.oUR EI,EJVATJONS
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<br />---------------
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<br />IS PRc),]EC'l' HI FiJ(IOfl ZOllE] AREAL] YElS
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<br />[J NO
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<br />BUll,IJIllR COMPA 111'______________._ __ _...__________._ ._.___
<br />STATE) CERT OR RI!lGIS'l' 1/ ______....____..__._....__..._.__._.
<br />SlmlA'I'URHl cay PROCESSING 11
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<br />B1LIllC'fRWIAN
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<br />l!OMP1\NY__~M__..tl~~_L~_u___ __,
<br />STATHl CERT UR RElIna'I' # .~~"'~LQJq_
<br />CITY PRUCH:SSTNQ ~_lJp_]__..__.______________ _h_"
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<br />S I (3Nli.'l't1R El __
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<br />pr~lJMBlllR CCJtiJPANy----________.._ .._._____.__,_._.__.___ _...._, ._
<br />STATE CERT OR PEl(HS'1' 11 __.______._ _____.___,__.
<br />S WNATUREJ CITY PROCEJ88Il1<3 II
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<br />*'*******************'**********~****************************.*,,*
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<br />MIllCHAN!(!AI,
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<br />CO~1PJ\N y ______ _________._.______._
<br />S'J'A TE cruRT OR REJ(~ r ST 11
<br /><'I'J'Y PRucrussnm II
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<br />O'l'HBlR
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<br />CO~IPANY
<br />STATE Ci!lRTQR-REGI ST./f----..----------------
<br />CITY PROCESSING # ---..-...-----___..__._______~.,__
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<br />--~.__._--------_._---------_._----
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<br />SIGNATIJRE
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