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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPART~ 5335 SU STREBT ZBPHYRHILLS, FL 33540 <br />PhoneIS13-7S0-0020 FaxIS13-7S0-0021 <br />DATE RRCBIVED <br />PLANS RBVIEW FRR <br /> <br />OWNER'S NAME ~ J0 ic.~ iA) \Ai }:. 12-0 .') S <br />JOB SITE ADDRESS S";;.:r S- 4 r..!:! .s " <br /> <br />PHONE CONTACT <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: <br /> <br />CONSTRUCTION <br /> <br />oc. ADDITIO~ <br />o MOVE <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />DMULTI - FAMILY <br /> <br />0# OF UNITS <br /> <br />o MOBILE HOME <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK Cf 1 C ru //1/ <br /> <br />L 'V < /-r:' rV c c... <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 RBQUBSTBD <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 <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLqCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLQOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES [] NO <br /> <br /> <br />BUILDRR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELIICTRICIAN <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />PLUMBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />" " <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 L(- L S .J< ~ i "r-,tJAAt'.s. <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />/7'1 <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />