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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 />OWNER'S NAME <br /> <br />A \ -Q/(Q/KdL\ -K\ -S. ~ <br />rvtl~cDl ~~U-^v~ <br /> <br />PHONE '7 'l i ,~ () .5 7 ? <br /> <br />JOB ADDRESS ~8\ lo~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />05 ~~S-d.I- fJO'7D,'ODOQ{) - 00(.1'/ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br /> <br />[] ADDITION <br /> <br />[]ALTERATION <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />[] SIGN <br /> <br />[]MOVE <br /> <br />[] DEMOLISH 'f2;L--r (.'(,( <br /> <br />PROPOSED USE: []SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBI LE HOME <br />[]OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D <br />UU>t 0 &w f'7-o~ Ct ~t1'liv-- <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />/-R. yt 0 c/ <br />. <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 />[] BUILDING <br /> <br />$ <br /> <br />f.1V <br />4, )-??J <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W,R,E,C. <br /> <br />[] PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br />BUILDER j COMPAN;?o.L.l\ ~Lh?~~C~ ~~,-L-..(, <br />C\ J! STATE CERT OR REGIST # C(., - Co 5 g I 4- <br />r CITY PROCESSING # d-..i? ~ <br /> <br />SIGNATURE ...~...~..~~............................................... <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />** * **** ****.* ** * ** ***** * **** * * * ** * ** ** * ** * * ** * * * * ** *** * ** * ** ******* <br /> <br />MECHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />