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<br />l".;J.'J.'.l VJf il:aJti.t'lt:t.Rt1J..l.ILS 'p~J:(MI'l' APPLICATION <br />aUILDrNG DEPARTiMENT 5335 B~ Street, Zephyrhil1s, FL 33542 <br />913-780-0020 FAX:B13-780-0021 <br /> <br />DAtE RECEIVED 7- 7- 0 ~ <br />.., PLANS REVIEW FEE <br /> <br />OWNER' S NM-~E ,fV1 A-ICI \~ 0nVeA. j silo, <br />JOB ADDRESS J75'11 G4 L( 131 v 6 ' <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />IOBTAIN FROM PROPERTY T~X NOTICE) <br />o ALTERATION ~PAIR 0 INSTALL <br />o DEMOLI SH <br /> <br />o MOVE <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOHE <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK 12e(J/A-c~ /hJStiL /:::-/1'2< 5~;Ji.p55t'q,..)Sy5jPrz, <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br /> <br />~ J-' <br />~ <br /> <br />PERMITS REQUESTED <br /> <br />o BunDING <br /> <br />$ <br /> <br />VALUATION OF <br /> <br />o ELECTRICAL <br /> <br />o <br /> <br />o PLUMBING <br />o ~lECHANICAL <br /> <br />$ ~)5V,~?O <br />I <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />'l'YPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br />[ ,,',:',",~ ,,,,,' .' ,,,.: ' , ' , " <br /> <br />. . . I <br />, '.... ""..JJU,~' '1'1 . ~ <br /> <br />.";,::,::"::'.~,:_~ <br />. ,I' .., , <br />: I I"', ';'r.' .~.." ,,' ,,~. ."."'" , ' I . H' <br /> <br />:,,,;,.,,... <br /> <br />STJrLDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING t <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELECTF.ICIAN <br /> <br />COt'1PANY <br />STATE CERT OR REGIST # <br />CITY PROCES~ING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />CO~~PANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING * <br /> <br />SIGNA'l'URE <br /> <br />***************************************************************** <br /> <br />OTHER h/Ze 5'(;::P12~.55 l~iV ,...0e !4-/~.~ ' CO~lPANyNPIIC'A/41V/.)," lih Y--5/rFef; {;o. (~ Tpr, <br />-4- (' ~ STATE CE"" OR REGIST # -93)')OmOOI/'1lfJ' <br />SIGNATURE ~ CITY PROCESSING # ~~_ <br /> <br />*******************************************************~(yI4~ <br />