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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 sth STREET ZEPHYRHILLS, FL 33540 <br />PhoneI813-780-0020 FaxI813-780-0021 <br />DATE RBCBIVBD <br />PLANS REVIEW FBB <br /> <br />OWNER'S NAME '0 A- C h (; (; / A <br />JOB SITE ADDRESS "3 f L( 2../ <br /> <br />PHONE CONTACT <br /> <br />F;'rr J ft (, e- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPS ED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />Os IGN <br /> <br />o MOVE <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 />D INDUSTRIAL <br /> <br />D SWIMMING POOL <br /> <br />DOTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D <br />2';E!, <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />~ fl(1I11e-6-l- =+- /.R~ /+ee S/:)^lJ <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 />D BUILDING <br /> <br />$ <br /> <br />IS-o 00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />D PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D GAS <br /> <br />D ROOFING <br /> <br />o SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o 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 />PLUMBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />OTHER <br /> <br />~")j;;;Z;'"'''''''' .::~::.. p;:;:" ~~:.~:...... <br /> <br />STATE CERT OR REG 1ST # 1%'1 000 0 <br />SIGNATURE CITY PROCESSING # <br /> <br />6'Lf3 <br /> <br />***************************************************************** <br />