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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BtJJ:LDING DEPARTMENT <br /> <br />DATB RECEIVED <br />PLANS REVIEW I'EE <br /> <br />OWNER'S NAME <br /> <br />~ .~ 0- 70 S-AJ ;-- d Q.,o- <br />r6? !) / ;ItA A.; VI ~cS-tow <br /> <br />PHONE <br /> <br />'7Re,~ 6'<;5 '3 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />c '3 -"A -~/- ()(.;:)r1 ~ {){)()~s: ($~ (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br />o DEMOLI SH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />OMULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />OMOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />t< J.- 7 .".. ~ <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />2~t 00 <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS <br /> <br />[] ROOFING <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br />SIGNATURE ".. ('~. /.~ ( Ic:'z- j,?~-Ll) <br /> <br />COMPANY fi?, c ;. ,4 .-t. fJ C've.//,<.J .v -1~ Ec.c<.,//(' t' C <br />STATE CERT OR REGIST # <br />CITY PROCESSING # tJ 77... <br /> <br />****************************************************************** <br /> <br />PLUYBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />**********~*********************************~**********~***~~ <br />, COMPANY ,.Q,.J N ~::.,/ ~. - <br /> <br />/'/"':./) //' STATE CERT OR RE 1ST # <br />t' //2:---v, / ( ~ - CITY PROCESSING # I' g ,;l... <br />-..'" ( . <br />/ ..../.7*** * ****"", ***** ** ** * * *** * * * ** **** * ** * * **** ** ** ** * * * * * ** ****** *** <br /> <br />\_/ <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />MBCRAHICAL <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />