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<br />L:..l'J.''t OF ZEl?HYRHILLS PERMIT APprJICATI01~ <br />BUILDING DSPARTMlllN'I' 5335 ~th S'l'RlllEl'I' ZlllPH'lRHILLS, FL 3354.0 <br />Pbon~1813-780-~020 F&KI813-780-0021 <br />DA'l'Bl RBCilIVBlD ~___~__.__ <br />PI.Al'lS RBlVnlW FJiBl________ <br /> <br />OHNI1:R I S NAI'1E 19 c::... ) At;" PHONE CON'l'AC'!, <br />,JOB SITE ADDRESS ~c.~ ;:J 1__~_~5-i!..I'.:.. __o/lK~________ <br /> <br />LEGAL DESCRIPTION: LOT IS) <br /> <br />SUBDIVISION k1~:5"'<-'oF~ eJAI;~ <br /> <br />BI-,OCK <br /> <br />PARCEL ID # <br /> <br />(OBTAIN Ii'ROM I?ROI?ER'l''l TAX Nfl'l'fCE) <br /> <br />WORK PROk"SED: ONEW CONS'I'RUCTION <br /> <br />o ADDITION <br /> <br />[J ALTERA T I ON <br /> <br />o REPAIR <br /> <br />D lm3T~I,II <br /> <br />DSWN <br /> <br />[J MOVE <br /> <br />[] DEI"1OlIISH <br /> <br />I?ROl?OSED USE: OSGL FAMILY DWELLING <br /> <br />[]MUL'l'I - FAMILY <br /> <br />0# OF UlU'l'S <br />[]SWIMMING POOL <br /> <br />f3lvJOBH.E HOME <br />D O'rtUilR <br /> <br />o COMMERCIAl, <br /> <br />[] INDUS'l'RIAI~ <br /> <br />D RESTAURANT &< HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />P,M- <br /> <br />BUILDING SIZE <br /> <br />SQUARE li'OOTAGE <br /> <br />HEIGH'I' <br /> <br />RESIDENTIAL: <br />COIYJMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS &< (2) SETS OF BUII,DIliG PLAl\JS ~ (1) SlilT l1lNiilJtqy F'ORMS. <br />A'l"l'ACH (3) SETS OF BUILDlW3 I?LANS &< (1) SET ENERGY FORMS, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~E~IT~ REOUE~TED <br /> <br />o BUILDING <br />rJ iilLElC'!'RlCAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONs'I'RUC'l'ION <br /> <br />AMI? ~ERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.lil,e. <br /> <br />[J l?WlvlBING <br /> <br />o Jo1ECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INs'I'AI,LA'l'HJN <br /> <br />[] GAS <br /> <br />D ROOFING <br /> <br />[] SI?ECIALTY <br /> <br />o O'l'HlilR <br /> <br />'l'YPE OF CONS'l'RUCTION: 0 BLOCK <br /> <br />o FRAlY1E <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FlNISHEP H{JOR EI,EVATIONS <br /> <br />I S PROJECT IN !<'LOOf) ZONE AREA 0 YES <br /> <br />D NO <br /> <br /> <br />CQti\PANY p~V <br />STATE CERcI' OR REGIS'l' # ______ <br />CITY PROCESSING # <br /> <br />BUILDIIlR <br />SIGNATURE _ 0-J'::;r- I!J~ <br /> <br />*"***"'.t***.**..*...*..*.**...*.*.....***...**...**t*****...... <br /> <br />COl1PAHY ~,4~J..... (( <br />STAT~ CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />111l,BlCT1U ClAN <br />8mnA'm.> __~ <br /> <br />._-----....-~......_- <br /> <br />***t***.*********.**.*.***.*..***************.*******.**..*.**.,.. <br /> <br />JilLUMBIIlR <br /> <br />SIGNATIJRE <br /> <br />cJ~~p <br /> <br />COMPANY -r: ~ <br />STATE CERT OR f{EGIST if__ <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />.****.**...****.*****.*****..*.**.***....********..,******''It***.* <br />COMI?ANY j'J AAA <br />STATE CERT OR RElGIST # <br />t.-l' ~ p~/ CITY PROCESSING If <br /> <br />*******.***.**************************~**.****************'tt**** <br /> <br />MIIlCHANICAIJ <br /> <br />OTHJilR <br /> <br />S rrmATURE <br /> <br />COl>1PAHY <br />S'l'A'l'EJ CEJRT OR REGIST # <br />cI'ry PROCESSING # -----__~.--- <br /> <br />***********~***************.....***..**.******.*******...***..... <br /> <br />--------.....~~~ <br /> <br />I <br />1 I <br />