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<br />CT'I'Y OF. ZKPBYHHII.J,S .PERMI'l' APPTJICA.'l'ION
<br />RUIUHNG DF.P.l\P,:l'MEN1' 5335 flTIl st, Zephyrh:tlls, F'l, 33542
<br />01.3...'] 80-0020 Fl\X: 813-780'0021
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<br />ON1'11: REeE [VED _.___._..___~~.
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<br />~HONE CON'rl\CT FOR PiRHIT'l'TNG
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<br />mvNF;H' s 11l\Hr:~_nyn')~~~~_____... '._..____..m____.. '.'__"~ ___..", PHONE _____....~._..__._..........____.,.
<br />.JOB 1\lJlJMSB...... -..34lt'2.t'~r~. !.;!.",,--. . __.. . ...._____....___..
<br />f,EGAl, VESCP.IP'I'ION: J,()'J.' (8) BLOCK SUBDIVISION
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<br />PA.RCET, 11.1 H.........
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<br />WORK PHorSE:O: ~\TEW CONSTIW(:T ION
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<br />r J l\J,DITJON
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<br />[11\ L,TERA.T ION
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<br />LJ BE P.l\lR
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<br />[j INS'I'Af,I,
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<br />I.] S IGl'I
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<br />rJ HOVE
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<br />[] DEHOl.lSH
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<br />rRUF.'OSF:U OSE:[lsf;l, F1\HU,Y mvE;r.JJUTG
<br />[1 CUHfvlJmCIAI,
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<br />CIHUI,T I ... FAHI L Y.
<br />[] INDUSTRIAL
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<br />Lilt ()Ii' TJNITS
<br />
<br />[1 MOBlLE; HOMF;
<br />[I OTHE:P
<br />
<br />II SWIHMLNG POOL
<br />
<br />DF:RCRJP'l'.lON OF WORK
<br />
<br />L~] RESTAURANT & HEl\.T..TlI DEPARTMENT APPRlJITAJJ
<br />Q ~.. t "-(' J V L
<br />\ l C7"t..ve. ..;.... fJ-' "J (1.\..J~.&^ '::)Cy\....- \A. (\.4"'\.._ {J--Ir
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<br />.........----- ...-(:,.----- SQlJl\RE F'OU'l'AGE ......._..__"....._. HEJ:fOFrr _._..__.._.__~_...,
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<br />BUrLDJNt; 317.8
<br />
<br />RF.SJDE~N'l'lAT,: l\TT7\CH (2) PJ"c)T PLAt.IS '" (2) SETS OF' BUIIrJJING PlANS
<br />CONMERCT1\fJ: l\'I"l'ACII (.3) SE'I'S OF' BUUd)ING PLANS & (1) S.F.T ENERGY
<br />IE' SH,N PF:HMIT ()Nf,y (2) SF;TS OF' ENGTNEE;RF.~D PLANS REQUIRF.L>.
<br />II \vun, ';1 L"n\o,pr:f'n"i~W\\{EY REQUIRED FOR ALL NE:W CONSTRUCTION.
<br />!'!I!,VAU)NIJC(H \I.':.!'I WII '1\l1I 1111.11:
<br />(:01)(<. NAIlONAI. PI H . f I)l( 'U 1I 11\ ^ Ii'
<br />('ITYOF1FPUYPlIlll ';I\HPIIIAi'JIF':
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<br />& {I) SET
<br />FOF!1S.
<br />/.l .
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<br />E:NEPGY FORMS.
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<br />) ~ '
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<br />j>)ttt (,
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<br />PERMITS ~QUESTED
<br />~-~~----... - . '. -......-.-~~
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<br />LJ BTJTI,IHIIG
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<br />$._~-_. ~--.'..
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<br />... ..-- VALUA'J'lON OF' 'l'OT1\J.r CONSTRUCTION
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<br />I.J ELE:C'J'Hll:AJ,
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<br />'.- .-.---..--- l\NP SJ<::RVICE
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<br />[] FLORIDA rmmn
<br />
<br />LJ W.R,r.:.C.
<br />
<br />,(I> PJ,UMBING
<br />tJ Mr~CHl\NICAJ,
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<br />Ll G.l\.8
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<br />[J ROOFING
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<br />[.I SPF.CIAL'l'Y
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<br />[] OTHER
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<br />HECHANCIAJ., INSTALLATION.'.
<br />."7 /,1"'"
<br />I;' / (0 /<.'J
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<br />$__.......__.____. ........__n____ VALUATJ ON OF
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<br />TYPJi: OF CONSTRUCTJON: LJ BLUCK
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<br />[J FRANE
<br />
<br />[] STEr~Jr
<br />
<br />[J OTHEH
<br />
<br />FINlSHF.1J FLOOR ELEVATIONS
<br />
<br />IS PHChTECT IN FLocm 7,ONEA.PEl\D U;S
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<br />[] NO
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<br />.._.._'_.-.----.~"_.,--_.._-------..-_------------------.-._--_._-_._-._--+.__..~._---_.----..~---~
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<br />CONTRACTOR SECTION
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<br />BUIT.,DER COHP ANY-.--..._______._.....______________....
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<br />SlGNl\.'rURfi: STATE CERT UP. REGTS'l' #
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<br />SIGNl\'J.'lmE -.
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<br />STA'l'E CERT OR Rr~(;TST ff ____...__.___.___.____._____...
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<br />SlGN1\TTJRF: STl\TE CEP,T OR REGIST # ______.._.___
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<br />OTHER
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<br />".;'~--._._~----_._.,_~..__._.~...u._.___..____________~ ..' _..*~__.....--__..___~_.._..._.
<br />
<br />COHPANY...._..___._ ".__ _. __....________.__.___
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<br />S TGNl\TURF:"........__._.... .... _...... .__............._._.._..._................__.__... STATE CERT on EEl; r S'I' j~
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