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<br />OI'lNEJR 'S IlM1E: ~.__k /'-~c.P..._.._L{Q~f-~~'~__._ ,. ________...._____.__ __________ PHONE CON/l'A(!'~'_.__ <<________ _____
<br />/.'"'
<br />,JOB S I'l'El ADDRESS?.,:,!_!'. ~-'l---____ __ ______________.___ _ . ________.. ____._____ ._.______
<br />
<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUIUJING DBlI?ARTMlllN'r 5335 8 th S'rRElEl'r ZI!JPH'lRHIIII,S, P'L 33540
<br />I?honeI813-780-~020 P'axI813-7BO-0021
<br />IJA'fl!J RBOJllIVlllo _.____. ..__~. _.____
<br />I?J,ANS RBlVIBlW rJllIII
<br />--'--'--'.---' --
<br />
<br />LEl(]AL IJE]SCRIP'1'IOI1: 1"O'1'(S)
<br />
<br />BLOCK
<br />
<br />SUBJJIVISIOll
<br />
<br />~..__._-_._._.__._---
<br />
<br />-'-'-"-~-,~- _.'~ '.- - ~ -___.- a, ____. ._~___ +__"._._
<br />
<br />PARC!ElIJ In II
<br />
<br />_...~.----_._~-~,--_._----- ---------<-----..-.---- _._--~_.__.._-_._-..... .-----.--...--... ..----~._-.-~--_._--_._--
<br />
<br />(OBTAIN FROM PROPERTY '{,AX NO'l'J('El)
<br />
<br />WORK PROPSElll I UNHlN C'ONs'rRUCTION
<br />
<br />[J ADDITION
<br />
<br />[JAL.'I'ERATIOH
<br />
<br />[] REPAIR
<br />
<br />U INSTAl,I,
<br />
<br />[JSIGIl
<br />
<br />[] ~10VEl
<br />
<br />[] DEWJU 811
<br />
<br />PROI:JU8EI1 USE: I L1SGII, FAMrLY DWELI,I11t~
<br />
<br />n~1lJl,'1'I' FAtvlIltY
<br />
<br />0# UF ON 1'1'8
<br />
<br />~El 1l0f11lJ
<br />(] OTHER
<br />
<br />[J CClt1HBlRC! fA I,
<br />
<br />rJ INDUS'l'RIAr,
<br />
<br />[J SW1f1MIN(] POUL
<br />
<br />IrnSCRIPTIUN OF WORK
<br />
<br />CJ R~IS'I'AURANT & HE:AUl'1I DEJPARTf.1EN'r APPROVAL
<br />
<br />
<br />
<br />.~..:...fL.____--:-------__ _ _______ ._________. ______.__._.
<br />
<br />----_._-_..~--------_...- -.--..----- _. ..__.._~
<br />
<br />8!JIr.rHNt~ S 1 ZEl
<br />
<br />----------- ._--_.__._---~
<br />
<br />SQUARE FOOTAGE
<br />
<br />--.- --------~----.--
<br />
<br />118WH'r
<br />
<br />RHl8IDENTIMJ I
<br />CO~1MElR(!IAT~ :
<br />
<br />A'I'T1\CH (2) PLo'r PIJAllS & (2) SElTS OF BlIIJ,DING PLANS & (1) SEl'1' ElNElRrn FORMS,
<br />]\'I'TACH (3) SE'I'S OF BUIJ.fJ!NG PLANS & (1) SElT ElNEJFH~Y FORMS.
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
<br />
<br />FEBHIIS REQUESTED
<br />
<br />L1 BlIn.DIN(~
<br />L1 EIJIllC'I'RICAI,
<br />[] P I.tJf1B I NG
<br />U HE<.!H1\NIC!ArJ
<br />
<br />$
<br />
<br />VALUATION OF TOTAL COHS'I'RtJc'rION
<br />
<br />- ---~-_._---.._.._---
<br />
<br />1\ti1P ,9ERVICEl
<br />
<br />D
<br />
<br />FU1RIDA POWER
<br />
<br />[1
<br />
<br />W,R.E,C.
<br />
<br />,
<br />$----.--------- VAIJUATION OF ~1a:C'HANCIAI, UISTAI,I,ATTON
<br />
<br />(] (ms
<br />
<br />U ROOFING
<br />
<br />[J SI?EOIAW'Y
<br />
<br />Cl OTHER
<br />
<br />'1'YPHI OF' COl~8'I'RUC!'rrcJl-l: [] BLOCK
<br />
<br />(] FRM1EJ
<br />
<br />(J STEEJ~
<br />
<br />[J OTHER
<br />
<br />F'rN I8HElJJ FI,OOR B1IJEVATIONS
<br />
<br />IS PROLTElc'!' IN FLoo!J ZONE AREAD YBlS
<br />
<br />(] No
<br />
<br />
<br />BUILnBlR
<br />
<br />~._--_._-_..._-
<br />81 {]!-1ATI1REl 0J-.' , -
<br />_...~- - ~.._- . ------------.-----
<br />
<br />******************************************************************
<br />
<br />ml,JIlC'rRICIAH
<br />
<br />S J (mATtJRE] _'_m
<br />
<br />cot1PANY _.J::t_<=::-.~___ ______________.__. ___.,
<br />
<br />~_ ~~__.___ ____________ ~'~~'~E P~~~~S~~N~E~IS'l' #------.-----_____u_._
<br />
<br />PI.UMBI!IR
<br />
<br />,.."..,.,....,..,....,...... H H. :,::::::. ~.~~':~...:------
<br />
<br />STATE CEJR'l' OR REGIST # ____~____ _~________..
<br />CITY PROCES8IN(] #
<br />
<br />._--_...__.._~-..__..__..,---- -_.~.--- '--~' -. _. --...-.. .._--_._.._~
<br />
<br />SIGNA'rlJRE ._.--~--~.L(~
<br />
<br />SWl'lA'I'!/RE ~~ ">- ~~#L7,______._.__
<br />
<br />******************************************************************
<br />cell'!] PAN V......!:f. ~~___.__.._____________ ___ _ '_,,___..
<br />STA'I'E1 CHlRT OR RElGIS'r # _______._____..._. __"n_________
<br />CITY PROCESSING #
<br />
<br />_.._...-.~_.._---_._-~.._--.._..---,..~---_.,---
<br />
<br />MBlC!HAUr CAr,
<br />
<br />-- --------------------.--..-----.
<br />
<br />*.************************************~**************************
<br />
<br />OTHER
<br />
<br />-......---------------
<br />
<br />cor,1PANY
<br />STATE CERT OR REGIST #
<br />CITY PROCESSING #
<br />
<br />~-_._-._--_.._._-_.-.-_..- .--.. .~.. ._-...
<br />
<br />SW1IA'l'tJRE
<br />
<br />_._----_._-~----_._-------.-_._-
<br />
<br />----_. ---~.,_.._-_.._.~._- .---'-- _._-
<br />
<br />*****************************************************************
<br />
<br />- -~_._-'-. ..-..---.-.-----.---- .-....-. ,--- -~._---~--,_.
<br />
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