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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 Sth STREET ZEPHYRHILLS, FL 33540 <br />Phone:813-7S0-0020 Fax:S13-7S0-0021 <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME A i c.. K 11 rJ Am c; PHONE CONTACT 7 g 3 - G ! 6S <br />JOB SITE ADDRESS '-I'lL{!' /7fA Sf.) 2e~YR.h,"j/~ FL S3Sl../0 <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />[] ADDITION <br /> <br />[]ALTERATION <br /> <br />[]REPAIR <br /> <br />[] INSTALL <br /> <br />[] SIGN <br /> <br />[]MOVE <br /> <br />[] DEMOLISH <br /> <br />PROPOSED USE: ~SGL FAMILY DWELLING <br /> <br />[]MULTI-FAMILY <br /> <br />[]# OF UNITS <br /> <br />[] MOBILE HOME <br />[]OTHER <br /> <br />[] COMMERCIAL <br /> <br />[] INDUSTRIAL <br /> <br />[] SWIMMING POOL <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK EtJiA1 chAnre-ou.i :2. +ON Sf, cool cO/IJJeAls&! <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 REQUESTED <br /> <br />[] BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />[] PLUMBING <br /> <br />0{ MECHANICAL <br /> <br />$ I :l00. 00 <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES <br /> <br />[] NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <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 />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />~ <br /> <br />--- <br /> <br />****************************************************************** <br />COMPANY 5luJ At'/l.. Sefl..UiCt::s <br />STATE CERT OR REGIST # CA co'l'-l~63 <br />CITY PROCESSING # <br /> <br />~ <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />