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<br />CI1!'Y OF ~J!iJ:'n .I..t\n.....u.uu ... .......-- - --- - -- <br />BUIILDING DEPARTMENT 5335 8~B at, ZephyrhiJ.ls, FT... 33542 .. ~ <br />813-780-0020 FAX: 813-780-0021 . CO\^ CI~ <br />J DATE RECEIVED~ <br /> <br />PHONE GONTACT FOR PERMITTING<t\3,-nL- 56)"9 <br /> <br />OWNER'S NAME ~ VV\€J\~n~~ . PHONE <('\)-1~l-%5f) <br />.JOB ADD""SS 3:1 C{ 9 >>A:t 1?r~ "\ rh.U,S FL--- "3 2,Sl{ 0 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 it <br />WORK PROPSED: []NEW CONSTRUCTION <br /> <br /> <br />DS~ <br />PROPOSED USE: ~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />Of 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 APrROVAI, <br /> <br />C1l7U;tN ~.+ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />(of/sO P1' <br /> <br />HEIGHT <;; Fl- <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 PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />tJo<.. <br />~os -/0 <br />PERMITS REQUESTED s\f-' t4fr..~J.- <br /> <br />$ <br /> <br />5,COQ <br /> <br />~UILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAY $ <br />o GAS~OOFING 0 SPE?ALTY <br />TYPE OF CONSTRUCTION: eyfBLOCK <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />VALUATION OF'MECHANCIAL INSTALLATION <br />o yfHER <br />dFRAME <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 /> <br /> <br />:::::E~rneN~e~~ett <br /> <br />STATE CERT OR REGIST i <br /> <br />EUCTRICUN lh~~;;Z~*i*****=H***::?i::* e OWNrI" <br /> <br />SIGNATURE v'/\JV~ STATE CERT OR REGIST I <br />****************************************************************** <br /> <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <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 />