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<br />APPLICA~ION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTME1~T <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />~ <br /> <br />\ <br />" <br /> <br />OWNER'S NAME STl::..t/e <br />.JOB ADDRESS ;3[2 _3 C; <br /> <br />B~ -r-i7 A(, <br />(1<- If-Jc- <br /> <br />PHONE 7<(;0 <br /> <br />?77'? <br /> <br />LEGA,J, DESCRT PTION: LOT (S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />Ie>- ;2..c;.. ~r 6 300 <br /> <br />066 () 0 <br /> <br />O~6 0' (OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />vJORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />.0 REPAIR <br /> <br />d'INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLI;:,H <br /> <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />To (,.J5'7?l-C-c <br /> <br />6.t 7111/ CHoL <br /> <br />~;c.f. r f(.rt j::1f-8 <br />{,rf <br /> <br />S'1fU1 <br />'ill <br /> <br />BUILDING SIZE <br /> <br />~~. <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMHERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />[J BUILDING <br />0 ELECrl'RICAL <br />0 PLUiJIBING <br />0 HECHANICAL <br /> <br />$ <br /> <br />9 () (;) roJ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ANP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o ~v , P.. E . C , <br /> <br />$ <br /> <br />VALUATION OF MECfUillCIAL INSTALLATION <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 n,EVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br />L_ <br /> <br />SIGNATURE <br /> <br />4:l It ~~C- <br /> <br />90~'+'MC'+'QR"~;m(z.'+'J;Q~ <br />5' 01./ S T1t-7 L. I'f Lv H (,v J J-f ---:z;j c.. <br /> <br />COMPANY <br />~n'ATE CERI' OR REGIST # <br />CITY PROCESSING # 70 t <br /> <br />BUILDER <br /> <br />*~*************,********************~****************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />ELECTRICIAN <br /> <br />********~********************************************************* <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />********~************~******************************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />MECHANICAL <br /> <br />***~*************k*k********************************************* <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />OTHER <br /> <br />*****k*******~************~*~******************k***************** <br />