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<br />CITY OF ZEPH'.lRHILLS PERMIT APPLICATION <br />BUILDING DEPART~ 5335 8~ STREET ZEPHYRHILLS, FL 33540 <br />Phone:813-780-0020 Fax:813-780-0021 ., _ '17_"'" _"" <br />DATE RECEIVED ~ c;;I- v ~ <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME <br /> <br />GdJ {/lei-11M ~~f /h-e. <br />/?c~&/ ( MIll ~ <br />57 <br /> <br />JOB SITE ADDRESS <br /> <br />PHONE CONTACT 78ff7J)J>'7 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />~~(j.fs: %t%jt $ rk <br /> <br />PARCEL ID # <br /> <br />WORK PROPS ED: tEW CONSTRUCTION <br />OSIGN <br />PROPOSED USE~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br /> <br />0# OF UNITS <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~af1~ ~^ cf- <br />BUILDING SIZE ~ y: tfO SQUARE FOOTAGE ~dfo ).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 />o BUILDING <br /> <br />$ <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 />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION:fd BLOCK <br />FINISHED FLOOR ELEVAT~~NS <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />(") <br /> <br />~16( {t1.~(/~ <br /> <br />STATE CERT OR REGIST # <br />CITY PROCESSING # Idf <br />. <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY <br /> <br />~r ,:tk-.. <br />. <br /> <br />BUILDER <br /> <br />ELECTR <br /> <br /> <br />* **************************************************************** <br /> <br /> <br />COMPANY h~~-t C(~G Re~ <br />STATE CERT OR REGIST # <br />CITY PROCESSING # /1.( b <br /> <br />(;~1lHB~ ~ <br /><.-:..!~v-::. .' ~" <br /> <br />************************************************ <br /> <br />COMPANY II~ 'f'Y) j~ ..r ti/ V,:r.. ( L) f'J i, <br />STATE CERT OR REGIST # JP~ <br />CITY PROCESSING # <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 />