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<br />I .... IlI7 t) cJ! -/1-0 J <br />CITY OF ZEPHYRHII~r~s PERMrr APPIJICA'rroN L ~~ # <br />BUIUllNG DEPARTMBlN'r 5335 8th g'rREBl'r ZJlJPHYRHII,I,S, FL 33e40 ___ <br />Phoner813-7BO-O,020 Faxr813-7BO..0021 /J <br />IJATBI RBC1J1]rVIlJD ~e5_~-l3.. ,::<2__3 <br />InANS R!llVIJIIW rBlBl.._~. u. <br /> <br />UI'lNER I 8 HA/I1Hl______G-'!.!I..f.'!.__~~~~..___________________________ PHONE (~ON'l'A<!'~'_______.. <br /> <br />.TOB S ITEl ADDRESS n -bk~-6./1.l!_i3Jj/..d..____________________ . ___ __._.__________. <br /> <br />J.J8H1AL IlHl8CRTP'l'IOtl: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />~--"----+---._-'- <br /> <br />---------.... ~____"v.___.__.. ___.______ <br /> <br />PARCEll, ILl It <br /> <br />HURK PRnpSElD I LJNElN (IONS'l'RUCTION <br /> <br />~--_.._----_.._.~.~--_.._-_._--_.._.__._-----~-----_..---'_.._-----_._-_.._-~-------.._._._._--~.-. .--------..--...-. <br /> <br />(OBTAIN FROM PROPERTY 1'AX NO'l'WEl) <br /> <br />rJ ATlDI'l'WN <br /> <br />o AUl'HlRATION <br /> <br />[] REPAIR <br /> <br />[J INSTAT,I, <br /> <br />[)SHm <br /> <br />[J ~10VE <br /> <br />o DEMOI,ISI/ <br /> <br />PRO[.>08EIJ USHlI [Jsm, FAMILY fJWELIJIllr,l <br /> <br />Clt1UI,'l'I.. FAMu,y <br /> <br />0# OF UNITS <br /> <br />[J MOBII,El Hor1E <br /> <br />[J COfilMEJRt! fA r, <br /> <br />rJ INDlJS1'RIAL <br /> <br />[JSVlI/IIMIWJ POOL <br /> <br />/] OTHER <br /> <br />. D ReJSTAURANT & HEJALTH fJEPARTr.1ElN'I' APPROVAL <br />)lHl8CRIPTWN OF NORK --&lLJ;#_E~ SI/~/o~~.d;!y:_.L I~-.lsi Id!.6____Jdp.iJi_. .u___ <br /> <br />BfJILfJINl3 SIZE <br /> <br />------_._--~_._----- <br /> <br />SQUAREJ FOOTAGE <br /> <br />REBItJlllN'I'IAf'1 <br />(~O)\1MI:!IIH!IAr, : <br /> <br />--. -----------.---- <br /> <br />HElHmT <br /> <br />A'I"I'1\CH (2) Pi,OT PI"AllS & (2) 8ElTS OF BtJII,DING PI/AN8 & (1) SEl'I' E1NElRl'lY F'ORMS, <br />A'I"liACH (3) sElTS OF BU!LfJING PLANS & (1) SElT ElNEJRny FORfIlS. <br />PROPERTY SURVEY REQUIRElD FOR ALL NEW CONS'I'RUCTION. <br /> <br />._'-~.._-.- ."--~,------ <br /> <br />~ERMITS REQUESTED <br /> <br />[] 8 \J II.IJI Nr~ <br /> <br />$ ---'-__h <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />LJ EI.,IlJCTRWAl, <br /> <br />---------------- <br /> <br />AMP SElRVICE <br /> <br />o <br /> <br />FllJRIDA POWER <br /> <br />[J <br /> <br />VI . R , E . (J . <br /> <br />[J P r.or18 INC3 <br /> <br />~lBIC1HAN I (.;AT, <br /> <br />$- --.'2.W-.::.._~_ VAI,UATION OF MECHANCIAT, H1STAI,I,ATTOI'I <br /> <br />r] GAS <br /> <br />LJ ROOP'ING <br /> <br />[J S PEC1 I AU!'Y <br /> <br />[) OTHElR <br /> <br />TYPEJ OF' COH8TRtJC!TION I [J BLOCK <br /> <br />[] FRAlIEl <br /> <br />[] S'l'EEIJ <br /> <br />[J OTHER <br /> <br />FINISHED FI~OR ELEVATIONS <br /> <br />-...._--~- <br /> <br />IS PROIJElC'I' IN FLOOD ZONEI AREA n YElS <br /> <br />o NO <br /> <br /> <br />Bunnma <br /> <br />****************************************************************** <br /> <br />corll PAN Y --.----- -..-- .________ ___ .___.. __'__.. _. "_.n___._. .__ <br />STATE! CElRT OR REl8IS'l' # __._____________..________.____.. <br />CITY PROCESSING L___.._.______....._______ ___..__.__._..... <br /> <br />SlmlATtJREJ <br /> <br />--~._- --'_._--_.~----~~_..._---_.._-----_._~---- <br /> <br />!lIT,mOTU a IAN <br /> <br />8 J (mATURE: __.._ <br /> <br />.... .._u_____ .-___._.h.__._____ .._.__'_._________~ <br /> <br />COliP ANY ____.___..____._ ______...______..__.______.___._. ___.__._ <br />STATE CERT OR REGIST # <br />CITY PROC88SIN<~ # <br /> <br />"----.-- '~--..__.,- .~----___..._...h_.,_____. '.__ <br /> <br />*h******h**h*****************************************h************ <br /> <br />-..---------.---- '--".__. -.----. --. _.~~-_...-....,_._--- <br /> <br />IiI I, tIMS ER COIY] P ANY ----.----------____h_________..__......_....._.____ __.._. <br />STATE CERT OR REGIST # __________.___._____._._..__......_ <br />BI<mA'l't1REJ CI'I'Y PROCEl8SIN8 # <br /> <br />MBKlHANICAl. <br /> <br />****************************************************************** <br /> <br />.....'-----_._._-------_._-~-"...__._---- <br /> <br />COlvJPANY ____________._ ... "'__ <br />STATE! ('I!1RT OR RElGIB'r # <br />CITY PROCElSSING # <br /> <br />--~ ~".._-------- ._-- ---0-- .__..____ __.. '..'____n_. <br /> <br />SIGNA1'tJREI' <br /> <br />*.* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *.* * * * * * * * * * * * * * * * * * * * .~ * * * * * * ~ <br /> <br /> <br />o'.r IIER -.- --:~ -~. __~.________.__ (~OI,1PANY ~~f~hiM_...;/LJ_ .-.f::_..__._J!_~-.--- <br />. STATE! c~bR REll'lI T # <br />s rml1\'l'lJREl F erry PROCESS ING # ______.___._____"__~.___.____ <br />- - .---~._------ --..----..o...e_1!t...____._____...._.____._._ <br /> <br />***********************************************************;***** <br /> <br />--'-------._,--~----- ..~-._-------. -,.~--~-~ <br />