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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />5--5~o <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />OWI'JEE' S NAME__~/; e~T"f 2>1<:.E.s . <br />JOB ADDRESS__~(:) ,~7 2U1I(,e..'j)6~ <br /> <br />PHONE 7" ~ d.o <br /> <br />J~ <br /> <br />LEGAL DESCRIPTION: LOT(Sj <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL TO If ~-3. U ,;)..1 <br /> <br />O/3() <br /> <br />(j646:) a1.(OIOBTATN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />~DDITION <br /> <br />OALTERATION <br /> <br />D REPAIR <br /> <br />o INSTALL <br /> <br />D SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED TJSE: OSGL ITAMILY DWELLING <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 />D RESTAURA!\jT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK ~ <br />BUILDING SIZE I ~~ <br /> <br />I A) "" r7'fc--l <br />! <br /> <br />I,;l.Y ~)5 <br /> <br />f/!7V ~F <br />;21*, <br /> <br />HEIGHT <br /> <br />SQUARE FOOTAGE <br /> <br />EESIDENTIAL: <br />COMt1E:RCIAL: <br /> <br />1l.TTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (l) SET ENERGY FORMS. <br />PROPEHTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />0 BUILDING <br />0 ELECTH:!:CAL <br />0 PLUMBING <br />0 MECHANICAL <br />0 GAS o ROOFING <br /> <br />$_____ II 30 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o vLR.E.C. <br /> <br />$-- <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 />l"INISHED FLOOH EU~Vl\TIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br />r--. <br />I <br />L-_________ <br /> <br />SIGNATURE <br /> <br />~?P ~~ <br /> <br />CO~~C~R'~'SE;<:~IQN <br /> <br />COMPANY .s t1~ :3 1>'frp <br />STATE CERT OR REGIST # <br />CITY PROCESSING ~ <br /> <br />BUILDER <br /> <br />/tWit t'1</()~ <br /> <br />7~ /- <br />'V' <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST #' <br />CITY PROCESSING II <br /> <br />SIGNATURE <br /> <br />****'k*******~*~*********************.***************************** <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***'~***i'********k*******************A***.'************************* <br /> <br />MECHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST tI <br />CITY PROCESSING tI <br /> <br />SIGN.r-.TURE <br /> <br />**********************~****************************************** <br /> <br />OTHER <br /> <br />CONPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />S:~GNATURE <br /> <br />k*~**k*****'************~**********Ak**~****A********************* <br /> <br />"'~'.-""""""."''''' <br /> <br />'~"W <br />