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<br />~ 'l~o <br />o <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 Sth STREET ZEPHYRHILLS, FL 33540 <br />Phone:S1J-7S0-0020 Fax:S13-7S0-0021 II () ( <br />DATE RBCEIVED n- 'J().- <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME 11 r~irs ~lte~/{!t1l <br />JOB SITE ADDRESS -?6 9 _ 2,.., /-/.;//5 <br />LEGAL DESCRIPTION: LOT (S) OJ... U ~ I BLOCKA / f(J <br />. <br /> <br />PHONE CONTACT 7d?f- tl57/ <br /> <br />PARCEL ID # <br /> <br />SUBDIVISION {)crrt) Od.-J() <br /> <br />WORK PROPSED: <br /> <br />EW CONSTRUCTION <br /> <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED <br /> <br />D/nGN <br />USE: ~SGL FAMILY <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DWELLING <br /> <br />DMULTI-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 />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />Dr;"ve VVfiy <br />" <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />A ,~(1) <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 />PERMITS REQUESTED <br /> <br />D BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />o PLUMBING <br /> <br />D MECHANICAL <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />$ ! <br />JSPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA 0 YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />~7w~~ <br /> <br />****************************************************************** <br /> <br />COMPANY C OA...C P er C(1.A.J~O()cTlo.I\J <br />STATE CERT OR REGIST # <br />CITY PROCESSING # ~ <br /> <br />SIGNATURE <br /> <br />ELBCTRICIAN <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 />****************************************************************** <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 /> <br />11., <br />