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<br />CITY OF ZElPHYRUIIJIAS PERMrr APPIJICA'l'ION
<br />BUIIJDJ.lW )lBPAR'l'MBlNT 5335 8th STRBlBl'r ZlIlPIIYRHII,IJS, Fl. 3]!540
<br />PhoneI813-780-0020 FaxI813-780-0021
<br />IJA'rm RIllCBIVBlD _____._____ ____
<br />PLANS REVIEW FEa
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<br />I OWHElR I 8 d'At'1El
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<br />,TOE S J'l'EJ ADDRESS
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<br />LIlJGAIJ DIllSCRJ PTION I I,clT (S)
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<br />BLOCK
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<br />SUBDIVISIUN
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<br />PARCEll, In #
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<br />WORK PROPSHID I ONHlI'i COH8'rRlJC'I'IOl'l
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<br />(OBTAIN F'Rm,] PROPElRTY 'I'AX NOTIC!H:)
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<br />[] ADDITION
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<br />C]ALTERATION
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<br />[] REPAIR
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<br />A'I"J'ACII (3) SEl'l'S OF BtHfJIJJlH3 PI,AHS & (1) BET EJllElRl3Y F'ORlv18.
<br />PRuPER'l'Y SURVEY REJQIJIREJD FOR AIJ1, NE!]W CONSTRIJC'l'J:rJN,
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<br />PERMI'rs RBl"UEs'rmn
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<br />COMPAtlY ___._____________, _..___._____...__ _ ..____
<br />STATEl CEnT OR RHlcHST II --.----.--_____h__.._________,_..
<br />CITY PROCESSING #
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<br />81l3l1A'I'UREl
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<br />S1LJllC'l'RICIAN COlo1PANY______.n.._n_______.
<br />STATE CEJRT UR RHlrHS'I' it
<br />SWN1\'J'tJREl --------.-_____.__________..______ CITY PROCElSSJNf~ It
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<br />PIJUMBllIR Coto1P ANY ___._______._____. __.___.,__._._._____ '.'..
<br />STATEl CERT OR REJCH8T II ____.________.._________._._
<br />8WNA'l'URllJ CI'l'Y PROCElSSIlm It
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<br />MIllCHANICAI.
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<br />STATE CERT OR REUIST #
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<br />SIGNATURE
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<br />CITY PROCESSING # ,~~---_______;___._
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