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<br />OWNRR'S <br /> <br /> <br />CI'l':i.. Or' ~o, ,dth......i.Lf:t ~ .~~..'lIld.IT AP"LICATION ...- <br />BUILDING nBPARTMBHT 5335 8th STRBBT ZBPHYRRILLS, FL 33540 <br />Phonea813-780-0020 Faxa813-780-0021' <br />DATB .BeBJ:VBD <br />PLANS RBVJ:JI1f FB. , <br /> <br />PHONE CONTACT 7 ~ ~ - ;15,) " <br /> <br />I:, ~)'\ <br /> <br />LEGAIJ DESCRI PTION I LOT (S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # } J...J. l:,--;;J.}- 0 ~) C..~ t)'-/Oo- ()\)()~ (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNRW CONSTRUCTION <br /> <br />[JADDITIO~ <br /> <br />[JAI.TERATION <br /> <br />DREPAIR <br /> <br />[J INSTAI.l. <br /> <br />[JSIGN <br /> <br />D MOVE <br /> <br />D DEMOLISH <br /> <br />PROPOSED USE: [JSGI, FAMILY DWELLING <br /> <br />[JMUIJTI - FAMILY <br /> <br />[J COMMRRCIAL <br /> <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING WoL <br /> <br />QhMOBILE HOME <br /> <br />[JOTHER <br /> <br />c:J RBSTAURANT &: HHALTH DHPARTMHNT APPROVAL <br />nBBCRIPTION OF WORK ~ ~~~ W)s;,,~ k ~ly R~\'b'tf" ~f/\bi'~~, <br />BUILDING SIZE SQUARE FOOTAGE ~ '-/3 ~. S HEIGHT <br /> <br />RESIDRNTIAL: A'l"fACII (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS 6i: (1) SET ENERGY FORMS. <br />COMMERCIAIJ: A1~ACII (3) SRTS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NKW CONSTRUCTION. <br /> <br />PBRMITS RBQUI~TBD <br /> <br />~ BUILDING <br /> <br />$bb35 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J RLBCTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />o PI,UMBING <br /> <br />o MBCHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECIIANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[J ROOFING <br /> <br />[] SPECIAL'rY <br /> <br />[J OTHER <br /> <br />TYPB OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />[] m'nER <br /> <br />i"INISIIED FJ.QOR EI,BVA'nONS <br /> <br />IS PROJEC'r IN FLOOD ZONR AREAO YES [] NO <br /> <br /> <br />SIGNATURB <br /> <br />COMPANY~ 1/ lJ: Yl~" b/e. A ~ 5 0 c.. <br />STATE CERT OR REGIST # C <: c.. 0 l.{ 9 3 b 7 <br />CITY PROCBSSING # /3 0 cr <br />V 0 IL-... , <br />*****.**.....*..**....*..*.***********.****.**.*.*..*........*.... <br /> <br />BUILDBR <br /> <br />BLBCTRICIAN <br /> <br />COMPANY <br />STATE CERTOR RBGIST # <br />CITY PROCESSING # <br /> <br />SIGNA1'URE <br /> <br />.......*..........................*..*....*.**.*.................. <br /> <br />PLUHBBa. <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING #' , <br /> <br />SIGNATURE <br /> <br />MBCHAHICAL <br /> <br />......................................................*.****.*.*.* <br /> <br />COMPANY <br />STATR CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />..***.***...****..***.**.***.**..**..**.****...**.**.****....***. <br /> <br />OTHBR <br /> <br />COMPANY <br />STATE CBRT OR REGIST # <br />CITY PROCBSSING # <br /> <br />SIGNA'rURE <br /> <br />****...*...**....*..**..**.*.*.**************..*****..******.***. <br />