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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION (~~-~~ <br />BUILDING DEPARTMENT 5335 Bth STREET ZEPHYRHILLS, FL 33540 ____ _ <br />PhoneIB13-780-0020 FaxI813-7BO-0021 <br />DATB RBCBIVBD __________ <br />PLANS RBVIBH FBE <br /> <br />JOB SITE ADDRESS <br /> <br />~Il\V<- <br />JO,(C) <br /> <br />; OWNER'S NAME <br /> <br />f:.../4 II <br /> <br />~~ S;-i:;>- 2-~ <br />;5 I ,,' .,J <br /> <br />PHONE CONTACT 35.2. -.5'16 -.:)1<)3, <br /> <br />4 'u"'-- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />(OBTAIN FROM PIWPERTY TAX NOTICE) <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALl, <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />D DEMOLI SH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br /> <br />o MULT I - F'AMI 1, Y <br /> <br />0# OF UNITS <br />D SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />D RESTAURANT & HEALTH DEPARTMEN'r APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />-:Ir-s T14' 14'i7 0..... <br /> <br />D;: ;.:..- S,tO--r Ai< 6>-v /t-'1-c tot , nJ n "',. <br /> <br />~JR_~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />C'0OMMERCIA~ 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 />r-;"'" f:>J:./"" <br />o ELECTRICAL <br /> <br />$ <br /> <br />J i 5YD.~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D FI,ORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />[J PLUMB ING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALIJATION <br /> <br />o GAS <br /> <br />~ SPECIALTY <br />'I'YPE OF CONS'X'RUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />o ROOFING <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />BUlLDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />BLBCTRICIAN <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 />SIGNATURE <br /> <br />MBCHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />OTHBR <br /> <br />***********~******************************. ********************* <br />r (P'L.. /}Iq.."yv/ <br />COMPANY 7lu.. 4milroP"/ CtJ . <br />//1/1 STATE CERT OR REGIST # ~F 000 002- 7 <br />/F (, CITY PROCESSING # ,lo,G/ 'ff ok. <br /> <br /> <br />' ., w, WC:"\ ';.,.,;: ~~' ~., (i ~~)' 3';; i'~" io'~~t 1Pzj <br /> <br />SIGNATURE <br /> <br />