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<br />~c&.~t I ~ .z!i - 0 :A U-- <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPAR~ 5335 8~ STREET ZEPHYRHILLS, FL 33540 <br />Phone:813-780-0020 Fax:813-780-0021 <br />DATB RECEIVBD / .....2. '1- tJ :l- <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME <br /> <br />/J:, I Ph If ('~o?tf-Cn,u=:, <br />sl;'f/] Pe.r {doT) h <br /> <br />PHONE CONTACTJi1y- '6i7-7T'3s <br />~-- ).pj erv lei /h. I ~ 7-P " <br /> <br />JOB SITE ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: ~W CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />D ADDITION <br /> <br />DALTERATION <br /> <br />DREPAIR <br /> <br />D INSTALL <br /> <br />DSIGN <br /> <br />DMOVE <br /> <br />D DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />DMULTI-FAMILY <br /> <br />D# OF UNITS <br /> <br />D MOBILE HOME <br /> <br />D COMMERCIAL <br /> <br />D INDUSTRIAL <br /> <br />D SWIMMING POOL <br /> <br />D OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK :5Cre..et( /(CJOVf/l -I- ....!Jhe.d <br />BUILDING SIZE ~O Yc? 0 SQUARE FOOTAGE RtJCJ~?J:J!. <br />&' <br /> <br />HEIGHT <br /> <br />18 J <br /> <br />, <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 />~UILDING <br /> <br />$ <br /> <br />?/M00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o 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 />D ROOFING <br /> <br />D SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />o 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 />SIGNATURE <br /> <br />COMPANY U U1 <br />STATE CERT OR REGIST # tri. 60 Y {,., 'i;/7 /J <br />CITY PROCESSING # <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />