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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECE:IVED <br />PLANS REVJ:EW FEE <br /> <br />~un \f-\.I.~-t <br /> <br />JOB ADDRESS <br /> <br />S4:35 <br /> <br />~LLt\ <br /> <br />Na~te <br />, <br /> <br />13\,,<:\ <br /> <br />Co a $+ <br /> <br />'2.e 1'(''1'1. y f ~ \ \ '\ 'S <br />SUBDIVISION <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />~TERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />~OMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />'REV'-" od. ~ \ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <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 />)('BUILDING <br />)'( ELECTRICAL <br />o PLUMBING <br />~MECHANICAL $ <br />o GAS 0 ROOFING 0 SPECIALTY <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />\:.;(15-\-""" ') <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE ~ <br />t/ <br /> <br />/7~ <br />{~ 4P7~ <br />[7 <br /> <br />COMPANY La:S"e-\-e..r COI'\.~('VC\\o""l '\V\C-, <br />STATE CERT OR REGIST # C~<=. o5~cn (a <br />CITY PROCESSING # 2 7 t/q <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br />SIGNATURE (-/@.l?_____ <br /> <br />Q77/~J2C~ <br /> <br />COMPANY"" C'_ Le.od E:.' ec..:\- r \ c--, \ Y'\c... . <br />STATE CERT OR REGIST # j?/'l 0 00 5-7 Y L <br />CITY PROCESSING # ;' ':(., \- (") k <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />t-J/A <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />**********************#******************************************* <br />"""""""CAL . ~ ~ COMPANY Ale. Co A,r CO"~I honl~, <br />~af . STATE CERT OR REGIST # ;CUHt9n";Wr <br />SIGNATURE......X' ' ~/. CITY PROCESSING # 27)() <br /> <br />I~. <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />t-J IA <br />. <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />