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<br />L:l.'J.':t; 01" ZBiPHYRHILLS PERMIT APPldCATION <br />aUILDING DEPARTMENT 5335 8th STREET ZEPHYRHILLS, FL 33540 <br />ihoneI813-780-~020 FaxI813-780-0021 <br />DA'.1'E RBCEIVIIlD ____._____ __.._____ <br />pr.AUS RlllVIBW Ji'BB_______,___ <br /> <br />OHNER 'S NANE (p/{J4N'J .lId/{ I 'l..v,v <br />JOB SITE ADDRESS Lf.'l ? ~ ~ J t'~ <br /> <br />PHONE CONTACT <br /> <br />....----...---------... <br />. <br /> <br />0->1,yvJ /{U,...., .......<....N <br /> <br />LEGAL DESCRIPTION: LOT(S} <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />WORK PROI?SliJD: (JNEW CONS'fRUCTION <br /> <br />(OBTAIN F'ROM PROPERTY TAX NOTICE) <br /> <br />[J ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o lNS'fAI,I, <br /> <br />Os IGN <br /> <br />o MOVE <br /> <br />o DEMOl,ISH <br /> <br />PROPOSED USE: []SGL FAMILY DWELl,nm <br /> <br />DMULTI - FAMILY <br /> <br />0# OF mu'l'S <br />[] SWIMMING POOL <br /> <br />(~E HOME <br /> <br />CJ COMMERCIAl, <br /> <br />[] INDUSTRIAL <br /> <br />o CymER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK .11/1, 11 <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEli3H'f <br /> <br />RES IDENTIAL: <br />COl'1MERCIAL: <br /> <br />AT'rACH (2) PLOT PLANS & (2) SETS OF BUII,DING PLANS & (1) SET ENERr~y Ii'ORMS, <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />FERMITS REQUESTED <br /> <br />o BUJLDING <br /> <br />$ <br /> <br />VALUATJON OF 'I'O'rAL CONSTRUC'l'JON <br /> <br />II ELEC'I'RlCAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />[] I? LUj\1B ING <br /> <br />o 1.1ti:CHAlHCAL <br /> <br />9__, <br /> <br />VALUATION OF MECHANCIAI. INS'rALLA'l'ION <br /> <br />o GAS <br /> <br />o ROOFIW3 <br /> <br />[] SPEOIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUOTION; 0 BLOCK <br /> <br />o FRANE: <br /> <br />o STElEL <br /> <br />[J OTHER <br /> <br />F'INISHlllD FLOOR ELEVATIONS <br /> <br />IS PROc1ECT IN l<"LOOfl ZONE AREAD YES <br /> <br />[] NO <br /> <br /> <br />BUILDER COMPANY (3~~~ <br />STATE OEJRT ~~~;~'I' #- _.___. <br />SlON'TDRE . .1.,.p?-=~:: eI'n PROC'ESSING JI'~ Iff <br /> <br />**~********.*.***********************.**.****t~q****..**.t*ttt. <br /> <br />El.BCTRICIAN OOI.rJPANY 19 c -e.- <br />,..-;: 77)'-) STATE CERT OR REGIST # <br />S](311ATURE --,1L::!...~Lf."-o/~ CITY PROCESSING # 01('---.-- <br />T' /D;( <br />*********.****.*..***.*******.**.*****************.**.***.**t****t <br /> <br />PLUill:lilR <br /> <br />SIGNATURE ----lA.J...J{;Z~:~~.. <br /> <br />COMPANY t:J~ <br />STATE CER'l' OR REGIST #- <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****.*.**.***.*******.**.**.*.*******.**.********.**.*********.t*. <br />he... ---- <br />COMPANY . .______ <br />~ STATE CER'f OR REGIST # <br />W ~, - CITY PROCESS ING #- 111 <br /> <br />· · · · * * '* · '* · '* '* · * '* '* ,* · '* '* '* '* · '* '* * * * '* * * * '* * '* * * * '. .' · · '* * . * * * * '* t * I< * * * * * p* ~ <br /> <br />MBlCH.lUiI CAr, <br /> <br />OTHBlR <br /> <br />SIcmATURE <br /> <br />COj\1PANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />**.******.**************.**...***.*****.************..**.**...*t* <br />