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<br />CITY OF ZEPHYRHIIJLS l?ERMI'!' APPIJICATION
<br />BUII,I>ING DEI?ARTMENT 5335 sth S'fREE'f . ZllJPH'iRHU,I,S, FL 33540
<br />PhoneIB13-780-~020 ra~telJ-780-0021
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<br />P1\R(!I!lI, I [l #
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<br />WORK PROI?8E1lJ I {JNEW r'f)NSTRUCTION
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<br />(OBTAIN FROM PROPERTY TAX NOTICE)
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<br />[]srGll
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<br />[] ADDITION ~/1'ElRATlnN [J RElPAIR LJ INSTAT,I,
<br />[] MOVE 0 bE~101,rSII
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<br />IlElSCRIPTION OF WORK
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<br />D R~8TAtJRAN'I' & HElAI,TH DElPJ\R'l't.1HlN'r
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<br />PROVA.L
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<br />RE8IDlllNTIM'I
<br />COMMBlR(nAI'1
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<br />A'I''f1\CH (;&) PLOT P1JA118 & (;&) 8ElTS OF BUIJ,DING PLANS & (1.) 8El'r E1NE:Rn'i FORMS,
<br />A'I"I;AC!H (J) s!1i'rs OF BUILDING PIJANS & (1) SI!lT ENHlRe~Y FORMS,
<br />PROPHIRTY SURVEY REQUIRED FOR ALL NEVI CONS'I'RTJCTION.
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<br />PERMITS REQUESTED
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<br />VALUATION OF '1'01'1'11, COH8TRtJCTION
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<br />LJ SPE(!IAUry
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<br />COt1 PAN Y___.._______.._______________.. .._.. __. .__ . _ ___._______ '_
<br />STJ\'I'E: CI!IRT OR RElGts'!' # ____.__..____._______.._____,.__....___
<br />CI'1'Y PROCESSING fL__ _____ __._______..__._ ___._.__._ .....
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<br />81GNATUREl
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<br />8"1 GW\TIJREJ ...
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<br />C<Jlo1PANY ___r/w ~'--_____~._____...__..__.._.___ __..__
<br />8TA'l'E CERT OR REGrST #
<br />CITY PROCESSING #
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<br />BlUldTRICIAN
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<br />COM PAtTy ----_______-,--______._.__.__...____.._____..
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<br />STATE CElRT OR REGIST # ____..________....
<br />CITY PROCESSING #
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<br />S WNATI1R E
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<br />HBlCHANI CAI I
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<br />(!()~1P ANY ______._____.___, .______._______ ...._._.._.._._
<br />STATE CElRT OR REGIST #
<br />CITY PRUCESSING #
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<br />SIGNATURE]
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<br />Cor-,1PANY
<br />STATE: C'ElRT OR REOtST #
<br />CITY PROCElSSING #
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