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<br />OOIN.R'8 NAM. 'V~~ 6~;t <br />,JOB SITE ADDRESS __5,/:2{) ~ 61l/_L____ <br /> <br />L:l'l'Y OF ZEPHYRHILLS PERMrr APpr~ICATr()N <br />BUILDING DEPARTMENT 5335 ~~h S'fREE'S' ZEPH"lCRHILLS, FL 33540 <br />~hon~1613~780-~020 F&xI813-760-0021 . <br />DA'J'Jil RBCEIVllID 7 .- ?a -- 0 :< <br />PI,ANS RlllVIJlIW Jj'BJll____h.~__ <br /> <br />PHONE CONTACT <br /> <br />---._-...~,-------- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />WORK PROf/SED; (]NEW CONs'rRUCTION <br /> <br />(OBTAIN };i'ROM PROPERTY TAX l'IO'l'+CEI) <br /> <br />DamN <br /> <br />D ADDI'fION o AurERATION D REPAIR D INSTALl, <br />[] MOVE D DE1"10I,ISH <br />DMUL'1'I - FAMILY 0# OF !nUTS [] MQB Il.E HOME <br />o INPUS'l'RIAr" o SWIMMING POOL, []OTHER <br /> <br />I?ROJ:iOSED USE; nSGL FAMILY DWELI,UW <br /> <br />o CDtiJMERClAI, <br /> <br />l1ESCRUTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />v:~ d- 12~ g=~- ExT. &b w.J..R +> 6oMt: S(,;cco <br /> <br />BUILDING SIZE <br /> <br />SQUARE FoO'rAGE !HUGH'r <br /> <br />RESIDE1~TIAL: ATTACH (:2) PLa'r PLAUS & (:2) SETS OF BUILDING PI,ANS & (I) SElT E)N.lilR(~Y FORMS. <br />COIv1MERcnAI"; A'!''l'ACH (3) SETS OF BUII"PlNG PLANS & (1) SET ENERGY FORMS 0 <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />lJ BUILDING <br /> <br />RERHIT~ REQUESTED <br />~ <br />i I, ()tOo ' VALUATION OF TOTAL CONs'rRuc'rroN <br /> <br />,Joe <br /> <br />$ <br /> <br />Ll ELEC'l'RlCAL <br /> <br />AMP ~ERVICE <br /> <br />o Fl,ORIPA POWER <br /> <br />o WoRoS.Co <br /> <br />o PLlJMBIW3 <br /> <br />o j.18)CHANICAL $ <br /> <br />VALUATION <br /> <br />OF MECHANCIAI, INS'J'ALLATWN-\; I <br />--.J 0 Vl '1 . <br />( ~(3) 2 ((t.(- ~ 739 <br /> <br />'-. <br /> <br />~ <br /> <br />o GlAS <br /> <br />o ROOFING <br /> <br />o SI?Jj;CIALTY <br /> <br />o O'l'HJj;R <br /> <br />'l'YPJj; OF COl~S'l'RucrroH; lJ BLOCK <br /> <br />o FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />l"INISHElD FLOOR ElI.EVATIONS <br /> <br />IS tlROc1ECT IN lo'Loon ZONE AREAo YES IJ NO <br /> <br /> <br />BUILDIilR <br /> <br />Coto1l?Ali/Y <br /> <br />EHGNATURE <br /> <br />.*k'*'.k**********.*..*..*.*****.******,**.*.***,**.*. <br /> <br />JU.JllCTRICIl\N <br /> <br />SIGNATURE: __ <br /> <br />COl>1PAHY <br />STATE CERT OR REGIS'I' # <br />CITY PROCESSING # <br /> <br />***"****"**'*t*******.*****,,**,****.*,*...*,****,******"'*'**' <br /> <br />iLUHBilR <br /> <br />COMPANY <br />STATE CERT OR ~EGIST # <br />CITY PROCESSING # <br /> <br />SIGNA'l'l1RE <br /> <br />MilCHANICAI. <br /> <br />***************************************************************.** <br /> <br />COMPANY <br />STATE CElR'f OR RElGIS'!' # <br />CITY PROCESSING # <br /> <br />*.~----....-_--- <br /> <br />SIGNATURE <br /> <br />**************************************~********************'*'*'* <br /> <br />OTHER <br /> <br />S HJl1ATURE <br /> <br />COMPANY <br />STATE CERT OR REGrST # <br />CITY PROCESSING # <br /> <br />*******************,********.********,***,*******,.**,********,.* <br />