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<br />CITY OF ZEPnYRHII~LS PERMJ.'r APPldCATION <br />BUILDING DEPARTMENT 5335 8~h STREET ZEPHYRHILLS, FL 33a4o <br />PhonElIB13~780-0,020 li'a.:X:1813-780"OOn .11 J. <br />DA'fm RBOl!lIVllIo ~~.L. ,31 P-![_~~_ <br />PI,ANS RlIlVIIlJW rSI. '.__ _,. '-'....__. . <br />011"8"" HAM' --13eLJ--C.iJ LClLJ-4 . dA D__P!L____ PHON' CON'I'W', ff!l ,~Ztt: Zbi'S <br />,TOB SITE ADDRBlSS__2.._f 5-l-____b:IfL$_L_________.__ _______ .-_~_..__.___n_____. _ ~ _.._ .__.. <br /> <br />LBlGAL DESCRIPTION: LITr(s} <br /> <br />B U)(~ K <br /> <br />SlIBlJIV I S ION <br /> <br />PARtlEl, III If <br /> <br />(OBTAIN F'ROM <br /> <br /> <br />R'l'Y 1'AX NOTICEI) <br /> <br />_.._..-.-_---_..~'---~-----_._._---_..._~--_.---.__._----_.-...---.----. -'---~--_.._--_... <br /> <br />WORK PROPSEIJ: [JNE~1 CONSTRtJr.~TION <br /> <br />[] ADDITION <br /> <br />[J ALTERATION <br /> <br />lJ THeTA!,I, <br /> <br />[Is IGN <br /> <br />[] MOVE <br /> <br />o DEMOI.ISH <br /> <br />PRtWOSEJIl USE: I nsm, FM1IIJY DWELI,IllG <br /> <br />[]~.1tJW' r.. FAMll.Y <br /> <br />[]# OF tINI1'S <br />[] SNH1~lING paUL, <br /> <br />[] MOB nEl lIot1El <br />U OTHER <br /> <br />(] Cot1MElR(~ JA T, <br /> <br />[] INDUSTRIAl, <br /> <br />BtJ!r,nrNt] SUE! <br /> <br />o RE:8TAURANT & HEALTH DEPAR'n1EN'I' APPROVAl.) <br /> <br />( n JL41L_t2fLL_dL'L li2~Z;4_/}-:';_Ln~__ <br /> <br />-----.---.----~ SQUARE FOOTAGE --.f!;!/224.fr H8I~H'r -=.-----."~C"--- <br /> <br />11BJSCRIP'l'ION OF WORK <br /> <br />R9JBIl1F.lNTIAJJ I <br />CO~1MBlRCIAIJ : <br /> <br />A'I''l'ACH (2) PI,oT Pl.)1\l1S & (2) SET8 OF BtJIlmNcJ PLANS & (1) 8B1T ENElRr~V FORMS, <br />A'I''l;A(!H (3) SE'I'S OF BUtLTJING PLANS & (1) SET ENER(~V FORMS, <br />PROP~RTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />FERMITS REQUESTED <br /> <br />[] BIIII.IJIN(~ <br /> <br />$ --..-- <br /> <br />VALUATION OF 'I'OTAIJ COHSTRUCTION <br /> <br />L.1 E1lJElCTRl CAr I <br /> <br />AMP ~ElR"ICEJ <br /> <br />o <br /> <br />Fl,ORrDA POWER <br /> <br />o <br /> <br />W,R,E1.Cl. <br /> <br />[] PI.t~ING <br />IJ~HANrC!AlJ <br /> <br />J p~ <br />--g /Jl? tJ <br />$-- -_/.1 ~( .~_.__ VAIJUATION OF ~~ECHANCIAL U1S1'AI,l,ATTON <br />./ <br /> <br />[] C~A8 <br /> <br />LJ ROOFING <br /> <br />[.I SPEC!!AUrv <br /> <br />[) OTHER <br /> <br />l'YPEJ OF (~ON8'rRtJc'rION I [J BLOCK <br /> <br />[J FRM"El <br /> <br />[] STElEL <br /> <br />[) OTHER <br /> <br />FINI8HElIJ FI.qOR mlJEV1'TIONS <br /> <br />IS PRO,JEC'f' IN FLOOD zemEl AREA [] YES <br /> <br />o NlJ <br /> <br /> <br />B t1 U,D Sl:R <br /> <br />Cot" PAN Y ____.____..__.._________ ~_.___..._ <br />STATE e'ERT OR REGIST # __.______ <br />CITY PROCESSING # <br /> <br />81 Gl'-l1\ 't'UR El _._._ __._____.____.._ ____________________ <br /> <br />****************************************************************** <br /> <br />ml,tII0TRICIAN <br /> <br />S'j mTATIJREJ __._ <br /> <br />,..p_64__ ,.._ ....~_.._._ _______~.____ 0._. .._"_.__. _"__. ......__ .__________ <br /> <br />CO~1P ANY _h___. .__._______ _._____ .____ _____..."__.___.__._._.._. ___.___ <br />STATE: CERT OR REGrST # <br />CITY PROCESSING # <br /> <br />.---.. ._-..~ '--'.-'~ .-....--...----....."-...-..--.. ._".....-. <br /> <br />*********'*******'*~*..***.**'*********************'**'*'******'** <br /> <br />0_..__.--. _"_'_~ ._.. __._ ~.._.._. _~~_".___.~_______ <br /> <br />Pl1UMSBlR <br /> <br />(!()r-! PANY-----------.--------.__-;-___ ..___.~.__..__.....__.__.. ._. _._. ..___________ <br /> <br />STATE CERT OR REGrST # __________"..__..___.____.___.... <br />CITY PROCESSING # <br /> <br />8 ICmA'l'tlREl <br /> <br />---..--. --.~.-. .____.~___._ 0_.- ."_'___..' __ _'__.'__ <br /> <br />* *' **' * ** * * * * * * * * *' * * * * * * * * * * * * * *' * * * * *t *' * '(*)')' * * * * ** *.* * * *[* * -;..* * *j~'4. "" fJ f/!'i <br />MBlC!HANI. C!Ar. 4- . . .. coll1 PAN vllL62L1Q vcr f1 ~AJL.02c:Mi_~_____!..:_:;c_..~_) <br />/' - --1--// < J1... . STATE ('ElRT OR REGrST # CA(125.H~.2?4.__.___..._. <br />8n.3NA1'lJ~E1 //.....____ _ZJL_~_ CITY PP~OCElSSING #____.._.__..__________._____ <br /> <br />****'*'***'************************'*"***'*'***'***'************ <br /> <br />O'rftBlR <br /> <br />S WNA'l'UREl <br />I <br /> <br />----.------.- <br /> <br />(~m..1PANY <br />STATE: CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />..............-......-..---------.-------------- <br /> <br />************************'**********************************~***** <br /> <br />-_.,--_--..&_.."--_._----~..--.---._-_.__...._- <br />