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<br />C.Jf.e<.rR I( -:1 7 - {:l ( Iq- <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DBPARTMENT 5335 Sth STRBBT ZBPHYRHILLS, FL 33540 <br />Phone:SI3-7S0-0020 Fax:SI3-7S0-0021 <br />DATB RBCBlVED 11- .;2? --- tJ / <br />PLANS REVIEW FBB <br /> <br />OWNER'S NAME <br /> <br />r~ , <br />~ A.. ~ 0"'-' 6 \<. \ <br />("l4' ~ ""'" S-,-.:- <br /> <br />PHONE CONTACT -, I Y ~, g <br /> <br />JOB SITE ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # 0:2 - ~ - ~/_ O!CfO-OO(1t?tJ-OISO <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />DSIGN <br /> <br />W ADDITION <br />o MOVE <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />o MULTI - FAMILY <br /> <br />0# OF UNITS <br /> <br />o MOBILE HOME <br />ol&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 .....s ~ <br />BUILDING SIZE --=t e (J' \~)( 't~ <br /> <br />. <br /> <br />.s (. Q 0 O'\.J Q.o 0 m ()- tjU'lJl() ...,~ <br />SQUARE FOOTAGE L-\ ~ 0' HEIGHT <br /> <br />~I <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />~~ :J- <br /> <br />)d BUILDING <br />o ELECTRICAL <br /> <br />, eO <br />$ \..~JO'O~- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <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 />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />(tf~ 3 ) <br />o OTHER ~ ~3 ((-I/O 5' <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDBR [\-, AW ~ ~ ~ e., ~,..l' \.:t)~ <br />SIGNATURE ,~ ~, <br /> <br /> <br />COMPANY ~~~ ~4A'LbO~ <br />STATE CERT OR REGI # <br />CITY PROCESSING # <br /> <br />lJ<..e S ~ e.e~. ;J.O . ,>1- <br />**************************************~ <br /> <br />BLBCTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COtJ/PANY <br />STATE CERT OR REG 1ST # <br />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 /> <br />'\ <br />