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<br />CITY Ol!' Ld!..t'n~t\n.1..LI.L1U A;",I.U."".,A...... u_ - -- ---- - - <br />BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br />pHONE CONTACT FOR PERMITTING ??/3 - 7g}- 95J{J <br />lZ,ck AJ;;fh ri(g <br />LI-- C PHONE &'13 83 7 <br />fh,"rJ t cltvY~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />ma~ s h c.. ()()jL, s <br />3Q'C;SO (11jI1reS> <br /> <br />BLOCK <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />~ALL <br /> <br />OSIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~ILE HOMl <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & <br /> <br />I.J6lcJ( <br /> <br />HEALTH DEPARTMENT APPROVAL <br /> <br />~1~ ~/yc:L <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 />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />,/ <br /> <br />/JU9 <br /> <br /> <br />/ <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o E~TRICAL <br />~LU~lBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTA]~LATION <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 />I S PROJECT IN FLOOD ZONE AREA 0 YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <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 />PLUMBER <br /> <br />SIGNATUF{E--~rlotlQQ ~wk~/J <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY Of)/YlMi st -lJ1JliflAlil 5 PI u /YI b <br />STATE CERT OR REGIST # Qpc /LlJ.56ad- <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />