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<br />OI'll~ER' SHANE ?~i<.. ~ofl J q tf~k~tJ <br />JOB SITE ADDRESS __61 2.L.._;z.. 0 Tit -.5 f_____________ <br /> <br />L:.J..'l'~ OF ZEPHYRHILLS PERMIT APpr~ICA'rION <br />aUILOING OSPARTMENl' 5335 ~th S'l'REE'1' ZEPH'iRHILLS, FL 33540 <br />Jilhonfltl813-7BO-O.020 FaxI813-7e0-0021 Jl- /./-0;>. <br />DA'rE RBCJilIVBO ~--I---:--c-='::;" <br />PI.1\.NS RBlVIl!lW FIB-------'-______ <br /> <br />~iK <br /> <br />PHONE CON'l'AC'I' 7 8 f-~ 3 J.- j. 7 <br /> <br />LEGAL DESCRIPTION: LOT(S} <br /> <br />-_.~--_..-- <br /> <br />BI~OCK <br /> <br />PARCEL 10 # <br /> <br />SUBDIVISION <br /> <br />1(-.1'-021- OO{D <br /> <br />(), 000- 0082- (OBTAIN Ii'ROM J?ROPER'l'V TAX ~Q'l'rCE) <br /> <br />WORK PROPSElD: Ol'lEW COl'lS'rRUCTION <br /> <br />o ADDITION <br /> <br />OALTElRATlON <br /> <br />D REPAIR <br /> <br />o n~S'l'#IJI. <br /> <br />DeIGN <br /> <br />o MOVE <br /> <br />D DEMor,ISH <br /> <br />l?R01l0SEIl USE: OSGlL FAMILY DWELLING <br /> <br />DMULTI - FAMIIJY <br /> <br />0# OF UNITS <br />DSWIMMING POOL <br /> <br />(J Mmur,E HOME <br />[~ER <br /> <br />o COMMERCIAl, <br /> <br />o INDLJSTRIAl~ <br /> <br />CJ RESTAURANT & HEJUmf DEPARTMEN'r APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE 8;( )0 <br /> <br />RES IDENTIIlL: <br />COJ>1MERCIAL: <br /> <br />80 <br /> <br />-- <br /> <br />SQUARE F'oo'rAGE <br /> <br />HEum'r <br /> <br />AT'rACH (2) PLOT I?LANS & (2) SETS OF BUII.DING PLANS CI (1) SEl'r ElNijlJtC4Y F'ORl"lS I <br />A'l"1'AOH (3) SETS OF BUILOlNG I?LANS & (1) SET ENliJRGY FORMfl, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION, <br /> <br />o BlHLDINf3 <br /> <br />$ <br /> <br />~ JOO' <br /> <br />~'~ <br /> <br />FERMITS REQUEST~ <br /> <br />[] ELEC'rRJ:CAL <br /> <br />VALUATION OF 'fOTAL CONs'rRuc'rION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E,C, <br /> <br />o PL[Jf'1BING <br /> <br />o HECHAN I CAI~ <br /> <br />$ <br /> <br />VALUATION OF MECHJlJ'1CIAL INs'rALLNI'ION <br /> <br />o GAS <br /> <br />CJ ROOFllW <br /> <br />o Sl?iCIALTY <br /> <br />o O'l'HER <br />~'1E <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />'l'YPE OF COH8'I'RUCTI01~; 0 BLOCK <br /> <br />FINISHED li'I,qOR EI,EVATION'S <br /> <br />I S PROJECT IN FLOOD ZOl'lE AREA 0 YES <br /> <br />~ <br /> <br /> <br />.UILll.. ~ ~ . (' <br />SIGNATURE ~LL l cJ~k <br />f <br />***..*****.**..*.*.*******..*.**.***...*.****.**,....***t***..*... <br /> <br />~~~ <br />STA'J'E CERT OR REG 1ST # ____ <br />CITY PROCESSING ~ <br /> <br />liILBlCT1UCIAN <br /> <br />S IGHA'ruRE __. <br /> <br />COl1PAlrt <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />----.-- <br /> <br />------ <br /> <br />Ji'L1JMSilR <br /> <br />*.*****...*..***.*.***.*...******************,*****..***********.. <br /> <br />----..----------- <br /> <br />COMPANY <br />STATE CERT OR JtEGIST # <br />CITY PROCESSING # <br /> <br />-----. <br /> <br />SIGNA'l'I1RE <br /> <br />MEeHANI CAr, <br /> <br />***.*.***********.*********.**.***********.*********,*******...*** <br /> <br />COMI?ANY_ <br />STATE CER'f OR REGIS'!' # <br />CITY PROCESSING # <br /> <br />--.............--.......-.- <br /> <br />SIGNATURE <br /> <br />OTHlllR <br /> <br />**.********.******.***.**.************~**.*****.******.*.......** <br /> <br />SIcmATURE <br /> <br />COf\1PAl'lY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />*****'*.*.*tt*.**.*********..**.*.*...*.**********...*...***.**** <br /> <br />J <br />J <br />