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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />$-;20-0 I <br /> <br />JOB ADDRESS <br /> <br />r0 or-Y\l u :r Le ~ L '('ie: <br />3'64 15 ~ ~ Ave. <br />I / ~ , <... <br />1/ - '2 lr 21- 6010~ O<6<t60 " 0 I; D <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />G l ~f~ . (<l 0 <br />r) .,.." \../ <br /> <br />~) ....78. / <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />~ <br /><",< r <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[JADDITION <br /> <br />[J ALTERATI ON <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED <br /> <br />Os I GN <br />USE:~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />[J MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br /> <br />;:I~ oclc,~ en, :O::R:^"'::E S ~~~ <br /> <br />HEIG~T ~ <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT <br />ATTACH (3) SETS <br />PROPERTY SURVEY <br /> <br />PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />OF BUILDING PLANS & (1) SET ENERGY FORMS.'" <br /> <br /> <br />REOU::~:::L~:~::::CTION. !frtf :~91~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION /)J~ eJf.-!15tJ <br />AMP SERVICE [J FLORIDA POWER [J w.R~(jc:q?1 <br /> <br />~ BUILDING <br />)lELECTRICAL <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />$ ,I; r200 <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />'fYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES <br /> <br />[] NO <br /> <br /> <br />BUILDER <br /> <br />S I GNATURE,'V'" <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY {) ~1A.J <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />ELECTRICIAN <br /> <br />V" <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />--..........~~".....~....._- <br /> <br />SIGNATURE <br /> <br />***************************** <br /> <br /> <br /># <br /> <br />*********************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />*****************************************,************************ <br /> <br />.. <br />