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<br />... <br /> <br />L:l"!'Y OF ZEPHYRHILLS PERMIT APPI~ICATION <br />BUILDING DEPARTMENT 5335 ~th S'l'REE'I' Z.IllPH'iRHILI,S, :FL 33540 <br />~hon./813-780-~020 FaxI813-780-0021 <br />DA'.l'E RBCEIVJIlD _______ __......,___ <br />Ii'I,Al-l'S R.IllVI.IllW i'BJIl__~__ <br /> <br />mINER I SHANE &. <br /> <br />, <br /> <br />JOB SITE ADDRESS 1 6 + <br /> <br />PARCEL rD # <br /> <br />-~ <br />qo <br />qO <br /> <br />;;2'1- -CJu- ;)-(- 6000 - CO/(}t) <br />~w CONS'I'RUCTION <br /> <br />,~~ <br />Co, J.j" "II <br /> <br />PHONE CON'l'ACT~~'i5-94?~ <br />~9() ~ ~ efer tLs O/"rtr:S. .//t..L~_~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BI,OCK <br /> <br />SUBDIVISION <br /> <br />WORK I?ROtlSED: <br /> <br />. oo1BTA.IN B"ROM PROPERTY TAX liO'J'fCE) <br /> <br />o ADDITION <br /> <br />o ALTERAT I ON <br /> <br />o REPAIR <br /> <br />o INSTMJ.l, <br /> <br />DaWN <br /> <br />D MOVE <br /> <br />o DEMOl,ISH <br /> <br />PR01'DSED USE: nSGL FAMILY DWELLING <br /> <br />OMUI/I'I - FAMII"Y <br /> <br />0# OF UNITS <br /> <br />P MQB Him HOME <br />o O'fUER <br /> <br />[]COMMIiIRCIAI, <br /> <br />o INDUS'l'RIAL <br /> <br />DSWIMMING POOL <br /> <br />D REeTAURAl~T 0. HE~LTH DEPARTMENT APPROVAL <br />) ~x ~O ;01. ( ()<~ 4:J <br />SQUARE FOOTAGE C--fc) <br /> <br />HEmurI' <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />RES IDENTIAL: ATTACH (2) I?LOT PLAl~S & (2) SETS OF BUU,DING PI,ANS Ell (l) SElT E;NIilRQV FOJiMS. <br />COIYlMERCIAL: A'I"l'AeH (3) BE'fS OF BUII,D:ma PLANS & (1) SET ENERGY FORMS, <br />PROPERTY SURVEY REQUIRED :FOR ALL NEW CONSTRUCTION. <br /> <br />o BUII.PrNG <br /> <br />RERMITS REOUEST~ <br />, '3 30.<0 D . VALUATION OF TO'l'AL CONs'rRuc'rION <br /> <br />$ <br /> <br />o ELEC'1'RlCAI, <br /> <br />AMI? ~ERVICEl <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.G. <br /> <br />o I?I,llMBING <br /> <br />o lYlIWHAN I CAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAI, INS'I'ALLA'l'ION <br /> <br />o GAS <br /> <br />[] ROOFING <br /> <br />o SPECIAl/l'Y <br /> <br />o OTHER <br /> <br />'l'1iPE OF CONS'I'RUCrION; 0 BLOCK <br /> <br />[] FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />l"INISHElD FI{JOR EI,ElVATIONS <br /> <br />IS PROdECT IN FLoon ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COtlJPANY <br />STATE CERT OR REGIS'!' If ___ <br />CITY ~ROCESSING # <br /> <br />SIGNATURE <br /> <br />**k*t******t*********************************..****.***.*....t.... <br /> <br />lU,BCTRI C UN <br /> <br />S I GHATlJRE __'__ <br /> <br />COtll PAN Y <br />STATE: CERT OR REGIS'l' # <br />CITY ~ROCE8SING # <br /> <br />._----------~----- <br /> <br />.****.***.************.**..*************.********.******...*.k.*.. <br /> <br />1?LUMBBlR <br /> <br />COMPANY <br />STATE CERT OR f(EGIST If_. <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />M.IllCHANI CAl, <br /> <br />***********k**k************************************************.** <br /> <br />COIVJPANY <br />STATE CElRT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />**************************************~*****************..**k**** <br /> <br />OTHJi!R <- rfl1c~ <br />SWNATURE ~--... <br /> <br />Gsn +lcfJcR- <br />l!~~~ '< p'L <br /> <br />COIYlPANY ~C/;~ e(fYl",AdA"1' /iJ4Sd71,.e~&_ <br />S'l'ATE CER OR REGIST If oc:A'777 J'2.H-s~' Co- . <br />CITY PROCESSING # -:--- ~~ .~_ <br />-:2- #/Lc.s~O R- <br /> <br />****t*t***********************.***************.*****..t*****....* <br />