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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DBlI?ARTMlllN'r 5335 8th S'rRlllllJ'r ZllJI?HYRHIr,IJS, ris 33Ei40, <br />PhoneI813-780-~020 'a~1813-780-0021 <br />W\.'fm RBCHlIIVJllb ..............~"-.:..~.i&C" ______ <br />li'IJANS R!llV I BlW J'SI_,-,-, ~_"__ L' Hq_____. <br /> <br />OI'lNEJR I S HM1El &1 ? ~~ c:: U 61[ <:F r?;~ PHONHl CON'l'Ar~'~_________~_~~:.c _____-' <br />-._---._-_..~-_._..- .._----~._---_._--_._--_...,'-_._..__.__.~.-------_._---------..-.. -------- <br /> <br />,JOB BITBl ADIJRBl88___::J.ip.:J_l_ ---12=__I!l~G_:..__________________ ________ ----------___H___________ <br /> <br />LBJ~AL DBJSURTP'1'IONI LO'1'(S) <br /> <br />-.-.--.----- <br /> <br />BUKlK <br /> <br />811BJJIV I S ION <br /> <br />PAR(~ElII III # <br /> <br />_.._..._--~--_..- - ., '---...----- ._-,-.- ----.- <br /> <br />---.-------~._---~.--.-----------.-..---.---~...~----.----_._.....u _.__._.,_________.~_ <br /> <br />(OBTAIN FROM PROPERTY '!'A){ NO'l'WEJ) <br /> <br />WURK PRnpSElIJ I [J NEW CONs'rRUC'T ION <br /> <br />[J UW1MBlRt!IAI, <br /> <br />n ADDITION o AL'rERA'rION [1 RIllPAIR I.J IN8TAlJl1 <br />o MOVE 0 DEf-10I,ISII <br />Ch1Ut/n - FAMIl.V 0# OF llNITS lJ MOB lItm 1I0f-1E <br />rJ INDUS1'RIAJJ [J SHIMMING POUL U OTHER <br /> <br />[j 8 IGN <br />PROI:JUI3EJJJ USE: r [~FAMILY DWELr,IW-~ <br /> <br />D Rl!l8TAURJ\HT & HEAlmr DElPARTt,1EN'r APPROVAL <br />nEBeRr onON OF WORK .____IZ~ _I!Q~..'! ?_~______~___ ____..________~___~_.__.___ <br /> <br />BUn,nrNt~ SIZE <br /> <br />-------..- . <br /> <br />SQUARBl FOOTAGE <br /> <br />R!llBIlHllNTIATJ r <br />COMMBlIWI AT,I <br /> <br />HEJJ~H'r .,_~__,_______ <br /> <br />A'r'I'l\CH (;]) PI,O,!, PI"AllS & (2) SElTS OF BUIl,DIl'l(l PLANS & (1) SElT E1NBJROY FORMS, <br />A'r'tA(~H (.J) SETS OF Butr.rnNG PLANS & (1) SElT ElNERclY FORMS, <br />PROPBlR'I'V SURVEY REQUIRElD FOR ALL NElW CONSTRUCTION. <br /> <br />[] BllILIJINc1 <br /> <br />RERMITS REQUESTED <br />$1u'?s D'"J <br /> <br />-_----....._~~_._.- <br />.-/ <br /> <br />VALUATION OF TOTAL CONs'nWCTION <br /> <br />L1 BlLBlCTRWAT, <br />[J PI.llMBING <br /> <br />-------- <br /> <br />AMP ~ElRVWBJ <br /> <br />o <br /> <br />FLOR IDA POWER <br /> <br />[J <br /> <br />N.R.Bl.C. <br /> <br />I.] IIJBlUH1\N WAIJ <br />[J W\8 [~OFIN(J <br /> <br />j- <br />$------ <br /> <br />-- VAIJUATION OF MH:C'!IAHCIAr, INS'I'AI,lJATTON <br /> <br />LJ 8PElCltAI/l'V <br /> <br />[) OTHER <br /> <br />TVPE OF (lONS'I'RUc!'rWN I [J Br.oCK <br /> <br />o FRAJ.1E! <br /> <br />[) 8'I'ElElI, <br /> <br />[) OTHER <br /> <br />FINISHBlIJ Fr.cJOR IllIJEVATIONS <br /> <br />-------~._-~ <br /> <br />r S PROIJElCT IN FLoon ZONE! ARElA [1 VEla <br /> <br />o No <br /> <br /> <br />I!H1UnIllR <br /> <br />-----------..--------.. <br /> <br />.~------~-~._--- <br /> <br />Cor1P ANY_______,_______________________ ______ ___________ <br />STATE CElRT OR REGIS'!' # _______________________,_______ <br />CITY PROCESSING L_______________________________________._ <br /> <br />810NATlJREl <br /> <br />B1UIClTRICIAN <br /> <br />****"'****'**"'*""'***'*'**********'*"'*******'**'*'*"****'* <br /> <br />COt1PANY ______ ________ _________________________ __.____ <br />STATE <'BRT OR REGIST # <br />SWI1ATlJREi -------.--'-----------.--__________________________ CITY PROCESSING # <br /> <br />-----.--.-......-... --.----..--.-.--..--.....-- -._. --_. <br /> <br />PIJUMBBJR <br /> <br />"*'**'*"'A"""'""***",**"**,,,,,*,*******,****'**'*****"* <br /> <br />----- ---.---.-..--. ~.-_..- -.,...- --->---.,__..a.____. <br /> <br />_._~----~--._..._--------- -. <br /> <br />-----.---- <br /> <br />(~OM PAN Y ------________.____________________.._____.__________ ._____.___ <br /> <br />STATE CBR'I' OR RBGIST # _________________________.. <br />CITY PROCESSING # <br /> <br />S WNA'l'lJR III <br /> <br />MBlCHANICAl. <br /> <br />~'*******'*************************************'*'****'*'***'**'** <br /> <br />--.--....-.----.---...--------.-- <br /> <br />COlvJPANY _______ <br />STATE nERT OR REGIST # <br />CI'I'Y PROCESSING # <br /> <br />------."....-..-- -------._._.._-._."_.~.._-- <br /> <br />SIGNA1'lJ~El <br /> <br />---..-----.-...- <br /> <br />----.--.-.--..----.-..--.------..-. <br /> <br />OT'.R ----j!~tf!I?_~~ ~ I4coh.c/? <br />8WNA'r'lJREJ _ ~__IJM: __ <br /> <br />*'**********'***********'********'****~**'***'**********'**"**** <br /> <br />-----.-----...------ <br /> <br />t /J ' <br />COMPANY t:-1'It//lt/ K O()//~6- <br />S'I'A1'El CElRT OR REGIST # 0 ~ l)olt~J~ ,------- <br />CITY PROCESSING # ~ _+----_______ <br />--Il_'~.____._________._____________ <br /> <br />***********************************'***************************** <br />