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<br />~..' <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8~ STREET ZEPHYRHILLS. FL 33540 <br />Phone:813-780-0020 Fax:813-780-0021 <br />DATE RECEIVED /0 - / t} - () / <br />PLANS REVIEW FEE ,. f <br /> <br />JOB SITE ADDRESS <br /> <br />GeV\e ~ <br />3~~ ~ ~ <br /> <br />~ ':beIH\ <br /> <br />~~~~" <br /> <br />I J.\ \ ~_ 1'-( BLOCK <br />, .;2. ~I ' ~l.-oi ()' <br /> <br />PHONE CONTACT <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />SUBDIVISION ~r..c.-\ ~ ,^)',l~.." <br />~ <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: GnfEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />0MuLTI-FAMILY <br /> <br />0# OF UNITS <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />D RESTAURANT & HEALTH DEPARTMENT <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE I OOC> <br /> <br />HEIGHT <br /> <br />'0' t,;' <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 />o BUILDING <br /> <br />$ <br /> <br />3~~1. ~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />D PLUMBING <br /> <br />D MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D GAS <br /> <br />o ROOFING <br /> <br />D SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />!ia""OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br /> <br />BUILDER <br /> <br />OMPANY ~ ~ ~ <br />STATE CERT OR REGIST # /2'1/. 00(" Cot ~ (l.. <br />, CITY PROCESSING # 1'/7.1 <br /> <br />..................................~~~~~~ <br /> <br />COMPANY ~ <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />ELECTRICIAN <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 />