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<br />CITY OF lGJ:!iJ!.t1 I. J:\n.LJ.I.LIi:) r .I:I.nJ.'~.A..&. ~............ ....,-- --.
<br />BUILDING DEPARTMENT 5335 8~H St, Zephyrhills, F.I:, 33542 1/ I
<br />813-780-0020 FAX: 813-780-0021 1/ 11.t!...J";-
<br />DATE m;9fI~D I, I l
<br />C,d!cdJ 'If .2. 0;0)
<br />PHONE CONTACT FOR PERMITTING
<br />
<br />OWNER'S NAME
<br />
<br />rg fZ Srn.a.r)
<br />
<br />;r~ <-
<br />
<br />PHONE a I'? -7/ y. /0 9 <i
<br />
<br />JOB ADDRESS S J S I S tt 41At~" H,t I 7),. ,
<br />LEGAL DESCRIPTION: LOT (S) I :<. ' BLOCK ;; C:,
<br />PARCEL ID # /{). 'J. Co -;)../- 0 /(!J()- OOCJOO-O:r~O
<br />
<br />SUBDIVISION ~ /
<br />
<br />(OBTAIN FROM PROPERTY,TAX NOTICEl
<br />
<br />WORK PROPSED: ~W CONSTRUCTION
<br />DSIGN
<br />PROPOSED USE:~L FAMILY DWELLING
<br />o COMMERCIAL
<br />
<br />o ADDITION
<br />
<br />o ALTERATION
<br />o DEMOLISH
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />o MOVE
<br />
<br />DMULTI-FAMILY
<br />o INDUSTRIAL
<br />
<br />0# OF UNITS
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOM
<br />DOTHER
<br />
<br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
<br />
<br />DESCRIPTION OF WORK
<br />
<br />S \.~~ I~
<br />
<br />F:t~ I (7 k? 5,'o/t:A\ e-<-
<br />SQUARE FOOTAGE / ~ l{ 0
<br />
<br />HEIGHT
<br />
<br />~I
<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
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW
<br />
<br />PERMITS REQUESTED
<br />
<br />
<br />
<br />~UILDING
<br />!H'" ELECTRICAL
<br />~LUMBING
<br />~ECHANICAL
<br />D GAS ~OFING
<br />
<br />$ VALUATION OF
<br />
<br />o SPECIALTY
<br />
<br />AMP SERVICE 0 Progress
<br /> ''\
<br /> VALUATION OF MECHANCIAL NSTALL~N t /1'2
<br /> / jI .
<br />D OTHER ( ,-
<br />D FRAME D STEEL o OTHER
<br /> IS PROJECT IN FLOOD ZONE AREAD YES ~O
<br />
<br />$
<br />
<br />TYPE OF CONSTRUCTION: ~LOCK
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />_'~'_~_'~'"_ ,,~___-,-,~_,,__'~_"'___'__._,_-_ ~________________ .. _ _" __,___"'__ --"_..---_I,----'-,--~__;..c=~~
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<br />~~~L.w__..;.1..,.~____~______~_____"~~.~___~~ ~ ~~"
<br />
<br />SIGNATURE
<br />
<br />~p~
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<br />y
<br />
<br />COMPANY
<br />
<br />B ~ /tev Bt.(dT [PHrr J~ L,
<br />
<br />BUILDER
<br />
<br />STATE CERT OR REGIST It C'Rc. 0 t; 85'3 e:,
<br />
<br />ELECTRICI~ ~
<br />SIGNATURt~
<br />
<br />********************~*********************************************
<br />
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<br />~ . -
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<br />
<br />E/
<br />
<br />COMPANY
<br />
<br />STATE CERT OR REGIST ltE~D...,....),.,7,r 7.d
<br />I
<br />
<br />PLUMBER
<br />
<br />COMPANYS:A~~,<, \\\~\~~,~ :"1_N(,
<br />STATE CERT OR REGIST # ~"'~:( \~~<,~C\.:)
<br />,
<br />
<br />M&lCHANI
<br />
<br />
<br />******************************~~~***~********~ ~ ~~
<br />~ COMPANl'--V h--l~~ \' _ t::!J.~
<br />
<br />STATE CERT OR REGIST * {!fJ~ fa 9 ~R'
<br />
<br />SIGNATURE
<br />
<br />*****************************************************************
<br />
<br />OTHER
<br />
<br />COMPANY
<br />
<br />SIGNATURE'
<br />
<br />STATE CERT OR REGIST #
<br />
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