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<br />l.;J.TY UJ!' ;Gt,;~lU:l'(H.lLLS .l?ERMIT APPLICATION <br />BUILDING DtPAR~NT 5335 8th StrBet, \.Zephyrhilla, FL 33542 <br />913-780-0020 FAX: 813-780-0021 /_,3 0 _ 0 "3 <br />DATil lUlCJilIVJ:D L._ <br />PLANS REVIEW FEE <br /> <br />OHNE." ."', (inn 1 'I I hi ill NaA i (In Cl \ \21\ 01\ '.0..('813.; 1'3::', '61 ~ ;:), <br />JOB ADDRESS (oq?fJ (~n { ~ ()\ '.rd. 2q>\\"I( \,( l\f~,. ~\. ?);':,'~~ (II <br /> <br />LEGAL D~SCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # Od. - a(O- d \ - 0010 - c:rYi;,0:) - OO:SO {OBTAIN <br />WORK PROPSED: DNEW CONSTRUC'l'ION AADDITION DALTERATION <br />OSIGN 0 MOVE 0 DEMOLISH <br /> <br />F~OM PROPF.RTY TAX NOTICF.l <br /> <br />o REPAIR <br /> <br />o WSTALL <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCI AL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o s~nMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK Ttl.s+nJ \ <br /> <br />AT M \''-'\0. c h \ (, t~_) <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ,ATTACH (3) SETS OF BUILDING PLANS & (l) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AM? SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMB1NG <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />o OTIiER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDI:R <br /> <br />~ l)(..(\..-~- C! <br /> <br />SIGNATURE <br /> <br />COMPANY r\"{l\/irl ~\O-,~fO((1 (('(e\,-:l-1'\(" <br />STATE CERT OR REGIST * c., - 000;;:),5/0 <br />CITY PROCESSING * I L{ (0 <br /> <br />*.*~**~**~***************..+*.**.***w*w********** <br /> <br />l'LlJHBJi:R <br /> <br />COMPANY <br />STATE CERT OR REGIST *_ <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />M&:CHANICAL <br /> <br />**********..*****+***~***********.**~~**************************** <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITy PROCESSING * <br /> <br />SIGNATURE <br /> <br />...**.~w~~*******~*****~~~~~*********+**~~~****~***************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />********.***********~*~~************.*********************w*...** <br /> <br />I . d <br /> <br />8698' ON <br /> <br />SlllHHAHd3Z iO f118 <br /> <br />Vi7ZI:01 8003 '8Z'H~ <br />