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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8th STREET ZEPHYRHILLS, PL 33540 <br />Phone:813-780-0020 Fax:813-780-0021 <br />DATE RECEIVED /6 -Ie.., - 0 ( <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME?,' ch.rc/ ~rc ,clo_~ PHONE CONTACTf'/3-7fZ< </<1'-15 <br /> <br />JOB SITE ADDRESS </5:;;~ /s;65S6~ 6/uol- 7-~ .33SY/ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />[J ADDITION <br /> <br />[JALTERATION <br /> <br />[JREPAIR <br /> <br />INSTALL <br /> <br />[JSIGN <br />PROPOSED USE~GL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[J MOVE <br /> <br />[J DEMOLISH <br /> <br />[JMULTI - FAMILY <br /> <br />[J# OF UNITS <br /> <br />[JMOBILE HOME <br /> <br />[J INDUSTRIAL <br /> <br />[J SWIMMING POOL <br /> <br />[J OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK (i ~ < '''"''" A- 0. -I Q. '~fJ" "-' LJ-'-t'" h ~ < <br />BUILDING SIZE SQUARE FOOTAGE 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 />[J BUILDING <br /> <br />$ <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 />[J PLUMBING <br />~ECHANICAL $ <br />[J GAS [] ROOFING <br /> <br />3lol{ J ~ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[J SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />D 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 /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />*****************************....*~~~~:;;.i;:s*;o;:.c:~~:~t'~ <br />~ /'./.. ~ _ J STATE CERT OR REGIST # 11 I'JS I <br />7 ~~...... CITY PROCESSING # ~_ <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />