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<br />OI'lNER'S HANE Cr-/I-/f...vJ j-{c.d'-r?..Jt.....:;
<br />JOB SITE ADDHESS __ '-:_....'1 ---t!!-.:> ~ 15 t.t..::L~d.~___
<br />LEGAL DESCR lPTION: LOT (S) I ()AJ BI.OCK
<br />
<br />L:l'l'Y OF ZEPHYRHILLS PERMrr APPI~ICATION
<br />BU1LDING DBJ?ARTMENT 5335 ~th S'l'REE'I' ZlllI?HYRHnI,S, FL 33540
<br />fhon.la13-780-~020 F&xI813-7aO-0021 C) yt
<br />DA'n RBCIlIVlllD ~ed~::..:' 2-
<br />I?I,Al'lS RlllVnW Ji'Blll___~~
<br />
<br />PHONE COl~'I'Ar.T
<br />
<br />fJ,)~ .
<br />
<br />SUBDIVISION
<br />
<br />(~~ A.vJ --;;:;-:.,--::-
<br />
<br />PAltCEL 10 #
<br />
<br />WORK PROtlSED: lJ I~EW CONS'fRUCTION
<br />
<br />(OBTAIN F'ROM PROJilERTY TAX NOTtCE)
<br />
<br />D ADDITION
<br />
<br />D ALTERA T I ON
<br />
<br />D REJilAIR
<br />
<br />D INS'rM~I,
<br />
<br />OSHm
<br />
<br />o MOVE
<br />
<br />o DEMOLISH
<br />
<br />PROJ:lDSED UtlE: OSG1, FAMILY DWELI,nm
<br />
<br />DMUl/l'I -- FAMILY
<br />
<br />0# OF lnU'l'S
<br />OSWIMMING POOL
<br />
<br />~I'E HOME
<br />OOTHEi\
<br />
<br />[J COMMERC IA1,
<br />
<br />D INDUS'l'RIAL
<br />
<br />o RESTAURAl~T & HEAL.TlI DEPARTMENT APPROVAL
<br />
<br />1i/JJ1Xh Ik-e- 4 ~
<br />
<br />SQUARE FOOTAGE
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />HElWHT
<br />
<br />RESIDENTIAl, :
<br />COI'<1/v1ERCIAL:
<br />
<br />ATTACH (2) I?LOT PLANS & (2) SETS OF BUILDING Pi,ANS & '1.) SElT EiNIilRqV FORMS,
<br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,
<br />PROPERTY SURVEY REQUIRED FOR ALL NIilW CONSTRUCTION.
<br />
<br />~E~ITS REQUESTED
<br />
<br />o BUILDING
<br />
<br />$
<br />
<br />VALUATION OF TO'1'AL CONS'fRUC'fION
<br />
<br />II A:LEC'I'RICAI,
<br />
<br />AMI? ~ERVICE
<br />
<br />o FL,QRIDA POWER
<br />
<br />o W.R,E.Il.
<br />
<br />o ~LlJj\1BING
<br />
<br />o /o1ECHAN I CAL
<br />
<br />$
<br />
<br />VALUATION OF MECHAl'lCIAI, INSTALLA'l'ION
<br />
<br />o GAS
<br />
<br />D ROQF'IlKJ
<br />
<br />o Sl?li;CrhLTY
<br />
<br />o OTHER
<br />
<br />'l':iPE OF COl~8'l'RUCTroN: lJ BLOCK
<br />
<br />o FRAME
<br />
<br />D S'l'ElEL
<br />
<br />D OTHER
<br />
<br />FINISHED FLqOR EI,EVATIONS
<br />
<br />IS PRO,1E:CT IN FLOOD ZONE AREAD YES
<br />
<br />D NO
<br />
<br />
<br />BUILDliJR
<br />
<br />CQtIJ PAN '{
<br />STA'I'E CER'f OR REGIST #__
<br />CITY PROCESSING # ~~/
<br />
<br />~
<br />SIGNATURE U 0-- ~
<br />
<br />****.,*'**,.,*',*..,***,**.*.*,*.,*,*.,..",..,*",..,.,.,.,......
<br />
<br />illI.BlOTRICIAN .
<br />SlC:lNATURE _L...-A~ '
<br />
<br />CO/IJPAHY /I c. "-
<br />STATE CERT OR REGTST
<br />CITY PROCESSING #
<br />
<br />ilLUWI:llllR.
<br />
<br />......................,........,.................:~J.lJ7..........
<br />
<br />
<br />COMPANY J?~~
<br />~~ STATE CERT OR ftEGIST #
<br />~ ~< ~~ ' CIT'{ PROCESSING # '1&'''
<br />
<br />#
<br />t.;:)
<br />
<br />.--.-------------.------
<br />
<br />SIGNATURE
<br />
<br />SIGNATURE
<br />
<br />"'*"'*'**'*'*************"*'*****"*********'***'*',*,,**,**..,
<br />COlvfl?ANY ./I- G '-
<br />STATE CER'f OR REGIS'!,
<br />CITY PROCESSING H
<br />
<br />MlilCHANICAL
<br />
<br />. U-A~~b
<br />
<br />#
<br />'IS
<br />
<br />*'******'*'***********'**'****'*******~*'***********"*".."",*
<br />
<br />OTH~R
<br />
<br />S HmATURE
<br />
<br />COf;1I?ANY
<br />STATE CERT OR REGIST #
<br />CITY PROCESSING #
<br />
<br />"'*'*'*'*"'*""""'**"""**'**"**'*'*"'*"'*",****,-.",
<br />
<br />---~
<br />
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