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<br />/ <br /> <br />I I <br /> <br />OITYOr ZBVHYRBILLS pERMIT APPLICATION <br />UUJ~IYG DEPAR~ 5335 Sd S~, ZGphy~hill., r.L 33542 <br />813-7BO-O~20 rAX:813-7S0-0021 <br /> <br />DA!r.l\ RJ:CJlrvlllD <br /> <br />PHOlU COND.C~ roll P.tum'TING Q\ ~ - -, cs- ~ - ~ S C{ t;.- <br /> <br />OWNER'S NAM&: <br /> <br /> <br />1<6~-gl~ <br />,\ ~\.":2 ~ - c-{l <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: <br /> <br />PARC&:!. 10 t <br /> <br />WORK PROPSEO: <br /> <br />DADDITION <br /> <br />~T&:RATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />Cl MOVE <br /> <br />o DEMOLISH <br /> <br />OMOLTI - FAMI!."! <br /> <br />Oi, OF UNITS <br /> <br />CJ MOBIL!!: HOME <br />o OTHER <br /> <br />CIAL 0 rNOOSTRIAL OSWIHMING POOL <br />~STAURANT "HEALTH DEPARTMENT APpROVAL <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br /> <br /><-'- ~~t..:...~_ <br /> <br />DESCRIP'lIOH 01' lfORI( !(" ~ . <br /> <br />o <br /> <br />HEIGHT <br /> <br />RESIDENTIAL I ATTACH <br />COMMERCIAL: ATTACH <br />IF SIGN PERMIT ONI. <br />PROPERT <br /> <br />(2) PLOT PLANS & (2) SETS O~ BUILDING PLANS <br />(3) SETS or BU~LD!NG PLANS & (1) SET ENERGY <br />(2) SETS OF ENGINEERED PLANS REQUIRED. <br />SURVEY REQUIRED FOR ALL .NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />rORMS. <br /> <br />PIlRMITS REQUBSTIlD <br /> <br />o BUILDING <br />~LECTRICAL <br /> <br />$ <br />E <br /> <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />SERVICE <br /> <br />o ProQress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS <br /> <br />o ROOrING D PECIALTY <br /> <br />TYPE OF CONSTROCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEl. <br /> <br />o OTHER <br /> <br />FINISHED FLOO~ ELEVAT eNS <br /> <br />IS PROJECT IN FLOOD ZONli: AREAO YES 0 NO <br /> <br />~ . -- -- _._"""""'--~ - - - ---~-'- <br /> <br />mJILDIlR COMPANY <br /> <br />SIGNATURE STATE CER'l' OR REGIST # <br /> <br />~.***..* ..********+.******.**************.**************....***** <br /> <br />IWlCtRICUN i <br />SIGNATURE c; <e... (} <r-~ ... --" It...- \ '" Q...LL- <br />u <br /> <br />COMPANY~~ T ~- .....1... \... 't \~~--\ S ~<" \.;>" ~ t".C':... -r...<--.c, <br />STATE CERT OR REGIST t E ~-~~ \ L ~ ~y <br /> <br />...*.*.* .*.***.****.***.**+****.~********.**.***********.***.**** <br /> <br />PIDGBlR COMPANY <br /> <br />SIGNATURE STATE C~RT OR REGIST * <br /> <br />.****... **********.*+****+*.********~.....***.~***.**.**..****... <br /> <br />MIICHl\l1(ICAL COMPANY <br /> <br />SIGNATURE STATE CERT.OR REG 1ST t <br /> <br />******** .**.****.***..****.**+*+~**.*..*************+*.********* <br /> <br />o~a COMPANY <br /> <br />SIGNATURE STAT&: CERT OR REGIST j/ <br />