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<br />CIrr'Y OF :6.t!iJ:'n~1'.n....J..IJ..I~ .. ..........- - --- --. <br />BUIILDING DEPARTMENT 5335 8H st, Zephyrhi11s, FL 33542 <br />813-180-0020 FAX: 813-180-0021 <br /> <br />DATE RECEIVED <br /> <br />:;)-c2/- Oy <br /> <br />PHONE GONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ;& / r d';{.P-./ ~h''',St rrJ~ /1 JS.z;:;iJ <br />JOB ADDRESS 49 ;lA. 4.,'... ~ r< yt .RJ <br />f <br /> <br />PHONE Y/3 - '7Ep--,{7G,{( <br /> <br />LEGAL DESCRIPTION: LOT(S) ~ <br />PARCEL I D it /3 - z (; - 7. I <br /> <br />BLOCK SUBDIVISION <br />_ 0010 <br />(j 0 ("0 - 000 IOn {OBTAIN FROM PROPERTY. TAX NOTICEl <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br />o SIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />Ji[COMMERCIAL <br /> <br />o ADDITION <br /> <br />IRALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />OMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />O. OF UNITS <br />D SWIMMING POOL <br /> <br />o MOBILE HO~ <br />DOTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APrROVAL <br />DESCRIPTION OF WORK (, ACt /I J P /) If? le-r 1-- /6, ,,1 /1 e I ~ ,3 - ;14a J e.. <br />BUILDING SIZE '.~" 07SX5U SQUARE FOOTAGE /Z 5~ 41 HEIGHT /4 r-/.., <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENE;B.G'l.-m~s. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, , <br />/ /''''",,\ <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />-'" <br /> <br /> <br />;:S-11( <br />l... <br /> <br />VALUATION OF TOTAL CONSTRUCTION ,...- <br /> <br />o BUILDING <br /> <br />$ <br />~() <br /> <br />o ELECTRICAL <br />o PLUMBING <br />D MECHA~ICAL $ <br />D GAS D ROOFING D SPECIALTY <br /> <br />AMP SERVICE <br /> <br />. Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />VALUATION OF'MECHANCIAL INSTALLATION <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br />j-;:- ~---;- ~- -- ;- -- -,- ,- .---- -- -.. -- . -, ~---'~~------------------', -- -, --, " --. -- - -"j - -- -- :-- ,-.--;-'-'~- <br />E~', I , " , " ,,-', I '" ' I,' '",11 <br />__~'" '--l-__-..___~__~__~ ___._____J._ ----------------- -- ~-~~ <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST . <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~~Jt#}- <br /> <br />COMPANY <br /> <br />O(ll~r..I~ f:Lk~'C. <br /> <br />ELECTRICIAN <br /> <br />STATE CERT OR REGIS'l' # EC {JM'I""SSJ.. <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 />r~k <br />~ " <br /> <br />.""--- -.- '''-''-''+ <br /> <br />.1,. <f;,.",./It1", -,~'tit",._,.~,j;''''''''';~ <br />STATE CERT <br /> <br />'R <br />,~ <br /> <br />SIGNATURE <br /> <br />REGIST # <br />