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<br />C1TY OF ZmPHYRHILLS PERMIT APPLICATION
<br />BUIr,DING OIlPARTM.IllNT 5335 ath 8'l'R.IllEl'1' ZBlI?H'iRHILI,S, Fl, ],3540
<br />~hon./813"780-~020 Fax.S13-780-0021
<br />DA'n REOBIIVIID ____._____,_."____
<br />Ii'I,ANS R.Ill\;'IlllW rBII
<br />
<br />OIiNER'. HAMSLhe, t~~ --~rnJl0-u:,------------H;- PHo"S CO",J'AC!T.J.J!i:-:..!.1J.L,
<br />,JOB 8 I'l'B1 ADDRBlSSJ_:2__Y_. 5__ I g }-~____~_t..:.______i. _-:_~JJ_S______..___. q__..___________..
<br />
<br />LEGAL n~ScRIPTIONI LOT(S)
<br />
<br />BI,QCK
<br />
<br />SUBDIVISION
<br />
<br />--.----...,.----.-
<br />
<br />I?ARCElJ If) #
<br />
<br />(OBTAIN PROM I?ROLlElR'l'V TAX NO'I'H!Ill)
<br />
<br />._-~---------._.._~----,~----....-
<br />
<br />WORK I?RClI?SI:1ID I lJNEW CONS'l'RIJC'rroN
<br />
<br />l] SIGN
<br />
<br /> ,
<br />[) ADDI'l'ION o AurERA T ION [1 REPAIR [J INS'l'M,I,
<br />Ll MOVE 0 DElMOI,ISH
<br />OMUW'I - FAMIlN 0# OF {IN I '1'8 (] MOBIf,1ll 1I0MBl
<br />o INPUS'l'RIAL o SWIMMING PO(J!, [1 OTIlBlJ\
<br />
<br />I?RClP08Elll USE I llsc,u, FAMII,y nWELLING
<br />
<br />fJ Uot~MBlRCIAI,
<br />
<br />BUH,DING SUE
<br />
<br />CJ RESTAURANT & HEAW'H IJElPARTMElN'l' APPROVAL
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<br />4 d ,_-AO~~_.___
<br />
<br />DESCRIPTION OF WORK
<br />
<br />SQUAREl F'OO'rAGE
<br />
<br />Hlillmrf
<br />
<br />RillS IDBlNTIAL I
<br />COMMIllR[!IAJJ I
<br />
<br />A'1"l'ACH (:a) PLOT PI"AllS & (J) SElTS OF BtJI J ,DING PLANS & (1) SElT BlNEJRflY i'ORMS.
<br />A'I"l'Al~H (3) BElTS OF BUIIJnnm PLANS & (1) SElT ENERGY FORMS,
<br />PROPIilRTV SURVEY RElQUIRED FOR ALL NEW CONS'l'RUCTION,
<br />
<br />FBRMITS ~EOUma11D
<br />
<br />[] I3\JIL1HNf3
<br />
<br />$--
<br />
<br />V1\L!1ATJON OF TO'l'AI, CONS'l'RUc'rroN
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<br />[] BlLBlC'!'RlCAL
<br />
<br />AMI? /3ElRVIUBl
<br />
<br />o FLORIDA POWElR
<br />
<br />o W,R,H.C),
<br />
<br />[J PLUMBING
<br />
<br />o 1<la:UUIUHUATJ
<br />
<br />$-_.
<br />
<br />VALUATION OF MElCHANmAI, INS'l'AI,LA'l'ION
<br />
<br />o 011.8
<br />
<br />o ROQFIHG
<br />
<br />[J S!?iCJIAVrY
<br />
<br />o OTHER
<br />
<br />TYPE OF CON8'I'Rl1CTlDN I [] BLOCK
<br />
<br />o FRANE
<br />
<br />o STEEL
<br />
<br />(J OTHEJR
<br />
<br />1<'INISHElIJ FJ.()OR Bll,EVATIONS
<br />
<br />I S PROd ECT IN l<'LOOfI ZONEJ ARIilA 0 VEllS /J NO
<br />
<br />
<br />BUILDIllR COtIJI?AN'l ~_._.,_____.______._
<br />Q"PI 0 n . I r: LIlA ^ STA'I'E1 CalRT OR RElGIS'!' # ~.____._.___________
<br />EHI1NATURE --_.L..J..IV~__.........L.L~--6:2J7 Q_ _ CITY PRO(1ElBSING L__._________..__,____._ ____
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<br />*************'h'******'******,****,*,****,*,,****,**,*"*,*,,t.**,
<br />
<br />JU,JII0TRICIAH
<br />
<br />CGt1PAHY
<br />STATE CERT OR REGIST #
<br />CITY PROCESSING #
<br />
<br />8] GHA'rI1RBJ __.__'_____..__._________~
<br />
<br />.~_.__.__._~--'--.-...---~-------...-.....
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<br />*'*'t*'******"*"'**'**'**""*,**,***""""",,,**",**"".,*
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<br />~---_.--.__._--_.__..,_....-....-.._.~-
<br />
<br />PLUMBIlIR
<br />
<br />--._-...._---~..._-_._---------------
<br />
<br />COMPANY ______.__.,____
<br />STATE CHlRT OR ~EGIBT It ________,_______.
<br />CITY PROCESSING #
<br />
<br />SWNA'I'IIRBl
<br />
<br />M.IllClHANI CAJ,
<br />
<br />****"""*'*"*'*'*****'****'***'****"**'*""""'*'********k"
<br />
<br />COIVJPANY_________,____~_._._~_________.__._._
<br />STATE CElR'f OR REGIS'I' #
<br />CITY PROCESSING #
<br />
<br />-----------.--------
<br />
<br />S IGl'lA'1'IlREl
<br />
<br />--~--..-~--~--
<br />
<br />*.********"*******'******'**********'~***'*********'*,**...*****
<br />
<br />OTIIIDR
<br />
<br />CO/>1PANY
<br />STATE CERT OR REll118T #
<br />CITY PROCESSING #
<br />
<br />S IlJHA'l'UREl
<br />
<br />-----~---._-----._-_.
<br />
<br />------------~-_.....---_...._--_.-
<br />
<br />**.*'*******'*'****'**'*"*""**"***'***"**'**"**********'***
<br />
<br />-------------._~--_._---
<br />
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