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<br />~~~y OF ~EPHYRHILLS P~FM!T APPLICATION
<br />~Ult.PING IHIPARTMENT 5335 ~th S'l'l'..:lill:l'r ZEI?HnHlt.LS. Ft. 33540
<br />ihonel 613 -780 - 0,020 Fli'.xl 813 -7 80 - 00":1 1(2 - /l, ,'C_ Q' ;,
<br />. DA'flll RBCEIVED ~~-~:../
<br />, ._--::_ -"'--'T.:P"
<br />l'hl>.NS REVIEW FBB_------
<br />
<br />mINER I SHANE /~ h ,;vi I~ ~ S
<br />JOB SITE ADDRESS ~7'/~V'.. a/A ,0-..________
<br />
<br />l?H()NE CONTAC.T
<br />
<br />-.........,......,.-----..--
<br />
<br />LEGAL DESCRIPTION: LOT(S) 073 tJ Br.OCK
<br />
<br />E'AR~EL ID # 5'-/.2 i-;2~ - ~ - ~I
<br />
<br />WORK PROl'SED: ......~~W COJ:::!s'rRlJCTIQH QI 0 ADDI'rION
<br />~17Jl.e V~M--iC PI '{ /14Are.
<br />o SIGN 0 MOVE
<br />
<br />(Jodi) 0 SUBDIVISION
<br />(OBTAIN !i'ROM 1?ROI?ERTY TAX ~n'l'+CE)
<br />
<br />07/0
<br />
<br />[] ALTERATION
<br />
<br />~REPAIR
<br />
<br />o IN6T~1,I,
<br />
<br />o DEMOI,ISH
<br />
<br />[] INDUS'l'R I AI.
<br />
<br />0# OF UNITS
<br />[] SWIMMING l?OOL
<br />
<br />[J MOBIl,E HOME
<br />IJ OTHEr<,
<br />
<br />I?RO\?USED USE: ~GL FAMII,Y DWELI,INGJ
<br />o ~OMMERCIAI,
<br />
<br />OMUl/1'I - FAMILY
<br />
<br />DESCRIPTION OF WORK
<br />
<br />CJ RESTAURANT
<br />A/EtU "7L1-t.~
<br />
<br />&. HEAl,TH DEPARTMENT APPROVAL
<br />
<br />..;- RNr ,. V/lY /</11-/( J IlIe. i ?/v~l~, . ~J6c.
<br />, I ' // /,,-
<br />
<br />BlJII,DING SIZE
<br />
<br />SQUARE Ii'OOTAGE
<br />
<br />BElLm'!'
<br />
<br />RESIDEHTIAL:
<br />COlvlIYlERCIAI. :
<br />
<br />ATTACH (2) PLOT PI.ANS &. (2) SETS OF BUU,DING PLANS 6. (1) SE'f ENIilRqy i"ORMS,
<br />A'!"l'ACH (3) SETS OF BUlI.DlNG PLANS & (1) SET ENERGY FORMS.
<br />I?ROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUC'fION.
<br />
<br />AMP ~ElRVICE
<br />
<br />i'~1~
<br />REQUESTED aJt.. h 1- &,,'1/ /
<br />71~'- -
<br />VALUATION Of? TOTAL CONS'fRlJC'rION . ,/ -- ~'.
<br />
<br />~ '
<br />
<br />o Fl,ORWA POWER 0 W .R,E. ~: ", 1) \,
<br />
<br />1Y1.wJ fUDG)
<br />
<br />VALUATION OF M'CHAl'CIAl. mS'I'AI.LA'!!:' ~~//
<br />[] OTHER
<br />
<br />[] E\IILDINCl
<br />fJ ELECTRICAL
<br />
<br />PERMIT~
<br />7~33S,oS-
<br />
<br />$
<br />
<br />[] I?LUl'1BING
<br />
<br />o I-1ECHA,H I CA1.
<br />
<br />$---,
<br />
<br />o GAS
<br />
<br />o ROOFING
<br />
<br />o SJ?ECIALTY
<br />
<br />TYPE OF C(}N8'l'RUCTIOl~: pf BIJOCK 0 FRAME
<br />
<br />FINISHEl1 FI,OOR EI.IlJVATIONS Vi'"5
<br />I
<br />
<br />[] STEEl.
<br />
<br />o OTHER
<br />
<br />IS PROe] ECT IN FLOOD ZONE AREA 0 YES
<br />
<br />~ l~O
<br />
<br />
<br />OI..CTRIC"~ ~ CO" PAl, ,diJJM,-/Cil/j p/t2:h-I'LFnf-T~
<br />" ,_ 01 --../ STATE CERT OR REGIS'l' # ~C ~[)t!1g'1,G
<br />Slm1ArURE-LL~~ ~l _ CITY PROCESSING # --::--- -~
<br />/t ;;I/}-6 () ,
<br />****...***.*.*.*********.**.**.**...........~~****.****t*...._
<br />
<br />ilLUMSBR 4L COMPANY ~:/~.r'~f /f~t;.7/,$ 1':=Y6/
<br />STATE CER'l' OR REGIST If l""1<="c'd??7F"/
<br />SIGNATOR'. _ _ q / _~ CITY PROCESS;,l1't # :Ag~. _
<br />
<br />.......*.*.*****..**...****.***************~~!~1~.~* **~~
<br />MIIlCHAlUCAL 1 COMPANY-~ Sc?t.t/,cJS.4/c-
<br />STJl.TE CERT OR REGIST # d,lJl~~ '1'lr---
<br />SIGNATURE fdL.f.- ~ CITY PROCESSING # ," 05' l
<br />
<br />~... ........................... ... ........ .... ..~~...........
<br />
<br />OTHOR ~ ~ COMPANY
<br />II STATE CERT OR REGIST #
<br />SIGNATURE t/ , el'rY PROCESSING #-
<br />. V:-3 tJ5"3 ,
<br />
<br />.*..*****..************.****.******.***.***Q~*.********....*.*
<br />
<br />CQtilPANY l3ttJt/lJ~ .-p..5'~JC. ..5'e~{//C "l..s
<br />STATE CERT OR REGIST # ~ZosoCRoJ Y (.'C COS-l>7f
<br />.::::::::::::::: CITY PROCESSING # gO?;Z
<br />\ - 111.1...
<br />*******.********.***.*.*******************.*.~*~**********..**.
<br />
<br />BUlt.DilR
<br />
<br />IHGNATURE
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