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<br />CITY OF iGJ!j.l:'t1.U:U1~.LI.LIQ r.l:l.nl..~""''&' .nl..._..._u_____
<br />BUILDING DEPARTMENT 5335 8TH st, Zephyrhi11s, FL 33542
<br />813-780-0020 FAX: 813-780-0021 / i,1
<br />DATE RECEIVED ~-I/ - oj
<br />
<br />PHONE GONTACT FOR PERMITTING
<br />
<br />OWNER'S NAME
<br />
<br />'I
<br />
<br />/) ~ "}-vv---
<br />'1 <i( ~ '7
<br />
<br />(1'- ~ .'.~~~ -
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<br />
<br />PHONE '127 - 2'1 3 ., 'f L--:;()
<br />
<br />JOB ADDRESS
<br />
<br />LEGAL DESCRIPTION: LOT(S)
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />PARCEL 10 t
<br />WORK PROPSED: ONEW CONSTRUCTION
<br />
<br />o ADDITION
<br />
<br />(OBTAIN FROM P~OPERTY TAX NOTICE\
<br />/ '
<br />o ALTERATION cYREPAIR 0 INSTALL
<br />
<br />o SIGN
<br />
<br />o MOVE
<br />
<br />o DEMOLISH
<br />
<br />PROPOSED USE: OSGL FAMILY DWELLING
<br />o COMMERCIAL
<br />
<br />OMULTI-FAMILY
<br />o INDUSTRIAL
<br />
<br />Ot OF UNITS
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOM
<br />o OTHER
<br />
<br />DESCRIPTION OF WORK vF
<br />
<br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
<br />f?,. J)J~ /-H,^,,-l P b v vi, .
<br />
<br />I
<br />
<br />BUILDING SIZE
<br />
<br />SQUARE FOOTAGE
<br />
<br />HEIGHT
<br />
<br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS
<br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY
<br />IF SIGN PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
<br />
<br />& (1) SET ENERGY FORMS.
<br />FORMS.
<br />
<br />'1:;i~UILDING
<br />o ELECTRICAL
<br />o PLUMBING
<br />o MECHANICAL
<br />
<br />$ v
<br />
<br />z ;; t./'V " v'\)
<br />
<br />'0
<br />.-:,$ ~/v(.;e .:/~..UI,/'.l'4 /
<br />PERMITS REQUESTED '_I~~
<br />VALUATION OF TOTAL CONSTRUCTION
<br />o Progress Energy 0 W~-R.-E-:"-C.'
<br />
<br />AMP SERVICE
<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 0 NO
<br />
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<br />
<br />BUILDER '. / /
<br />SIGNATURE ~. _ ~~Li~
<br />
<br />COMPANY\/'/ I~ ''4- /) Vl.1'I,...(A..
<br />
<br />STATE CERT OR REGIST #
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<br />******************************************************************
<br />
<br />ELECTRICIAN
<br />
<br />COMPANY
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<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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<br />******************************************************************
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<br />PLUMBER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
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<br />STATE CERT OR REGIST *
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<br />******************************************************************
<br />
<br />MECHANICAL
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<br />
<br />STATE CERT OR REGIST *
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<br />*****************************************************************
<br />
<br />OTHER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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