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<br />CITY OF Z~!:'t1:t~n.J.L1.1-1U ... ...----- <br />BUILDING DEPARTMENT 5335 8TH st, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />1":J1~D;- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />JOB ADDRESS <br /> <br />MQ'I~ \J~loSC~V~0 <br />SCp 0 f . cr-ffA 5'-f <br /> <br />PHONE <br /> <br />g'! 3.7gg'3() 9/ <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />IOBTATN FROM PROPERTY TAX NOTICE) <br /> <br />PARCEL ID # <br /> <br />o SIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOt" <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL <br /> <br />L0M13/J\f0 ~<$.w\~~ <br />NTh "'4 T::>K.. <br /> <br /> <br />HEIGHT <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />...."'-~.- - .---- <br /> <br />'.'" <br /> <br />'\ <br /> <br />/ <br />..../ <br /> <br />o BUILDING <br /> <br />$ <br /> <br />// 5) <br />PERMITS REQUESTED / ;~ . ~ I / <br /> <br />VALUATION OF TOTAL CONSTRUCTIO~ <br /> <br />AMP SERVICE 0 Progress Energy 0 <br /> <br /> <br /> <br />W.R.E,C. <br /> <br />o ELECTRICAL <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE 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 AREAO YES <br /> <br />o NO <br /> <br /> <br />~ BUILDER <br /> <br />SIGNATURE j(gch:J LafJ ~' <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />'/.- PLUMBER COMPANY <br /> SIGNATURE STATE CERT OR REGIST # <br /> MECHANICAL COMPANY <br /> SIGNATURE STATE CERT OR REGIST # <br /> <br /> <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />