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<br />CITY OF ZEPgYRHILLS PERMII~ APPLICATION <br />BUILDING DBPARTMENT 5335 at.ll STUET 1~}!PHYRHILLS, FL 33540 <br />Phone:B13-7BO-0020 Fax:B13-7BO-0021 , ~' ~ <br />' DATE RBCEIVED -LL..- -0 <br />PLANS REVIBW FEE <br /> <br />OWNER'S <br /> <br />NAME~r;~DyLr VnD..CC~ <br />. f'-....\,or~ Av~ <br /> <br />PHONE CONTACT g 1.3 - ""? 5' cl- g :;) 2 (... <br /> <br />JOB SITE ADDRESS ~ ~ 0 3 I <br /> <br />. - <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # 0 ~.....:J ~_ ~ l.- () ooh ... 0 0 to 00 _ DO \ I:) (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPSED: DNEW CONSTRUCTION 0 ADDITION DAL'J~H:RATION 0 REPAIR 0 INSTALL <br /> <br />pJs IGN <br /> <br />D MOVE <br /> <br />o DBI"IOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />DMULTI-FAMILY <br /> <br />0# OF UNITS <br /> <br />o JIIIOBILE HOME <br />D OTHER <br /> <br />~ COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />DESCRIPTION OF <br /> <br />CJ RESTAURANT <br />WORK !n ~al\l ^ ~ <br />"I 5 ~ 00' <br /> <br />& HEALTH DEPARTMI!:NT APPROVAL <br /> <br />BUILDING SIZE <br /> <br />cJ- o.~\ le..~s 0 r-. <br />SQUARE FOOTAGE 'IS 00 <br /> <br />ra..~a.y > <br />HEIGHT I 5 . <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />ATTACH (3) SETS OF BUILDING PLANS & (1) mi:T ENERGY <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CON~I~l'RUCTION. <br /> <br />PERMITS REQUES']'lI!:D <br /> <br /> <br />& (1) SET ENERGY FORMS. <br /> <br />FO._,,:::-'), _ Q <br />.I QZ-\~ <br />/tJ D~ / '1 ')' .:- -~-I ~c. <br />.' j).~ <br />~ <br /> <br />iii BUILDING <br /> <br />$ 40 ~ I. Do <br /> <br />VALUATION OF TOTAl, CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o W.R.E.C., -5' <br /> <br />~' -'6;\ <br />VALUATION OF MECHJINCIAL INSTALLATION l' q ~ :J. <br />o OTHER / <br /> <br />[] <br /> <br />FLORIDA POWER <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT <br /> <br />[] NO <br /> <br />SIGNATURE <br /> <br />COMPANY_ J~t/1l 0 <br /> <br />/ / ~ ~i'. .; STATE CHRT OR REGIST <br />D ....,~jt--t.-~?'l/tl/ CITY PROCESSING # <br /> <br />**** * * * * * * * **** * * ** * iIr ******* ** * ** ** * * ****~, j~ * ***** * ** **** *J'*** ** * <br /> <br />BUJ:LDBR. <br /> <br />BLBCTR.J:CIAH <br /> <br />COMPANY__ <br />'~--'--' 'STATE-"CIrRT-~'Rl!;G.IST'"-#- <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />******************.**********************~'.*********************** <br /> <br />PLUMBER. <br /> <br />COMPANY-- <br />STATE CmtT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />*****************************************~************************ <br /> <br />MBCHANJ:CAL <br /> <br />COMPANY__ <br />STATE CgRT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE Cm~T OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />