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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />//-&, - tlO <br />DATE RECEIVED . <br />PLANS REVIEW FEE <= <br /> <br />OWNER'S NAME AN'M' <br /> <br />JOB ADDRESS <br /> <br />r~ ~~L PHONE <br />.3"p~ )/t/ ~AlJlEI 2H~-..~ <br /> <br />?rI"~-J>~~ <br />3M1'/i> <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # I/-';t '';/''Oe>/P-/''"'-P&>// <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~EW CONSTRUCTION <br />DSIGN <br />PROPOSED USE:)nsGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />.. <br />DESCRIPTION OF WORK /AJ"'~ <br />.::P~ ' 1>" J '/9' <br />BUILDING SIZE .;1v t:I ~'/7 <br /> <br />bt:;A I'IJ'JJv~ ~ at! ~,~ <br />SQUARE FOOTAGE d IP~ <br /> <br />HEIGHT <br /> <br />/~/ <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT <br />ATTACH (3) SETS <br />PROPERTY SURVEY <br /> <br />:!2l BUILDING <br />~ELECTRICAL <br />)9- PLUMBING <br />~ECHANICAL <br /> <br />$ ~~ptIV <br />,2 t>t? <br /> <br />PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />REQUIRED FOR ALL NEW CONSTRUCTION'(j) '--J7..t2-J- NcJ~ <br /> <br />./ ( <br />'" If II ~.~ <br />PERMITS REQUESTED (J)...6../ (J&1<<L.>r5~~~ <br />~v~~~~. <br />VALUATION OF TOTAL CONSTRUCTION V <br /> <br />AMP SERVICE 0 FLORIDA POWER 0 W, R, E. C. <br /> <br />$ <br /> <br />.2 ,QD~ <br />. <br /> <br />o VALUATION OF ME(C~~ :S:~O:~ '#~tnU <br />OTHER v~, 'If - cr'l/5:-" <br />;a. FRAME 0 STEEL ~--aQTH~R "."..!}______.--- <br />IS PROJECT IN FLOOD ZONE AREAO YES ~ NO <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />SIGNATURE <br /> <br />A 7J~ <br />^J <br /> <br />****************************************************************** <br /> <br />/', <br />(~ <br />U?/LIUL , ___' <br /> <br />COMPANY fj ft'1t ~.rr"krl;..J <br />STATE CERT OR REGIST # G.8-ePS'7/d/.;!L <br />CITY PROCESSING # ~~ (iU <br />v' ,- <br /> <br />BUI:LDER <br /> <br />SIGNATURE <br /> <br />COMPANY /hAt/'U ~e~r";c.- <br />STATE CERT OR REGIST # <br />CITY PROCESSING :/;t~fL.. ~K <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />S I GN.P-.TURE <br /> <br />/;J~ <br /> <br />~ <br /> <br />~1uLC <br /> <br />COMPANY owner <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />PLUMBER <br /> <br />'" <br /> <br />**~~********************************************~*~*****~** . <br />....CllJ\NICAL~ ' COMPANY ~.-h.e 'll,"n_;.z" ~1Mi~ <br />/ - <br />> STATE CERT OR REGIST # <br />SIGNATURE _ 'm.._ ~ t, t-f L ~L>~A:iTY PROCESSING 111Sr'I- <br /> <br /> <br />* * * * * * * **** * * * * * * * * * * * * * * ** * * * * ** * * * * * * * * ** * ** * * JI'.. * * * * * * * * * * *'* * * <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />