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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 sth STREET ZEPHYRHILLS, I1'L 33640 <br />PhoneIS13-780-~020 l1'axI813-780-0021 <br />PATS RBCJIIIVlIID, _~'"'-_._ <br />j ) PLANS RlIlVIBlW [II . ." <br />OWNER' a NAMs f\o.-S h n furnl :Sfu (e.-0 PHON. CON'l'A"'~ ),3A3.;('7~ <br />JOB alTO ADDRsas 13;]5 Croil Gh/cJ, ".2eP)i<h; i1-s I V L. 335+) <br /> <br />._-~.-- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BIDCK <br /> <br />PARCEL ID # ..J...L/ ~ ;< J 0606 O(lgQJ OOdO (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPSED I ONEW CONSTRUCTION 0 ADDITION '(i'ALTERATION ~ REPAIR 0 INSTAlJIJ <br /> <br />SUBDIVISION <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOI,ISH <br /> <br />PROPOSED USE I DSGL FAMILY DWELLING OMULTI - FAMILY 0# OF UNITS <br />~COMMERCIAI' 0 INDUS'1'RIAL OSWIMMING POOL <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK {(e.. - ~ <br /> <br />o MOBII,m IIOMIll <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HB/WH'I' <br /> <br />RESIDENTIAL: <br />COMMBlRCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUII,DING PI~ANS & (1) SalT ENERGY FORMS. <br />ATTACH (3) sEl'I'S OF BU!LDING PLANS & (1) SET ENElRclY FORMS, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />P!RMITS REQUESTED <br /> <br />o BUILDINCl <br />[] ELECTRICAL, <br />o PLUMBING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONs'rRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E,C, <br /> <br />o MECHANICAL $ <br />o GAs ~ ROOFING 0 SPECIALTY <br />TYPE OF CONS 'I'RUCT ION : 0 BLOCK <br /> <br />[] OTHER <br /> <br />VALUATION OF MECHANCIAl, INSTALLATION <br /> <br />tit I~J ODD~}l <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR EJIJEVATIONS <br /> <br />IS PROclECT IN FLOOD ZONE AREA 0 YES 0 NO <br /> <br /> <br />BUILPBlR <br /> <br />COr1PANY <br />STATE CERT OR RElGI8T # _._ <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />IIIIJBCTRICIAN <br /> <br />S JGNATURE ____ <br /> <br />COr1PANY <br />STATE CERT OR REGrST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />PLtIMBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNA'l'tJRE <br /> <br />MBlCHANICAL <br /> <br />***'*****'*********'***'***'*********'***'*****'********'***"*"* <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />OTHBlR fc'OF/'r1 G- <br />BWNA'l'URE ~~~ <br /> <br />*****************'**'***"*********'*'~**********'********'****** <br /> <br />COMPANY U;t!.r/j ;20CF/jG {V . <br />STATE CERT OR REGIST # (!..~()3d-.Lj 0/ ~ <br />CITY PROCESSING # ~L/~ <br /> <br />**************'***********'*********'*********'****************** <br />