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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUIl.DING IHlJPARTMENT 5335 8th S'fREE'f ZBlPH'iRHH,I.S, FL 33540 <br />PhoneI813-780-Q020 FaxI813-780-0021 <br />IJA'rB1 RIllCJ!lIVBlD ___. _. _ _ __ H___ <br />PI,iU'fS RBlVII!JW FEll <br /> <br />OWNER'" IlAM'.__-1!AiI!c.d"l?c;~__..._-_ .ll:J;;>.{-~ .13u-t..-yw"," mN'l'wr. __.. __ _ .. _ . <br /> <br />,JOB SITE ADDRBJ88 -.-5!i23.-.-..t:d~___.af~____.__ _____..___ '.'_~_.__________._. <br /> <br />LEl~AL DESCRIPTION: L~r(SI <br /> <br />BU)('K <br /> <br />SUBDIVISION <br /> <br />PARC'EI, HI If <br /> <br />- ----------_._..__._-----~.- -------- ---~----~---~-----_._- _. .~-~-_.._--_.._-- --.----.-...-.-. "'---~'.- ..~--_..--_..._~ <br /> <br />(OBTAIN F'ROM PROPER'ry 'J'AJ{ NOTWEl) <br /> <br />WORK PROPSElJ I [JNElN CONSTRUCTION <br /> <br />[] AnIJITIOl'T <br /> <br />[JAI/I'EJRATION <br /> <br />[] REJPAIR <br /> <br />[J IN8TAU, <br /> <br />[]SHnl <br /> <br />[J MOVE <br /> <br />o DEJ~10I,ISII <br /> <br />PRO(,lUSEJIl tJSElI C1SGI, FAMIIJY DNEl.IJIllG <br /> <br />Clt1tJliI'I. FAlvtn,y <br /> <br />[]# OF UlH'l'S <br /> <br />lJ MOSII,El Itot11ll <br />[] OTHER <br /> <br />Ucm1MIllRC!IAI, <br /> <br />[] HmUS'l'RIAL <br /> <br />fJ SWH1MING POOL <br /> <br />BUIr.rHNG 91ZEJ <br /> <br />o R~STAIJRAN'r & ll'AI'Z~TM'N'r APPROVAL <br /> <br />JJtJ2-~J~~~ u~~_ --U(j2--?;~~r~~T_..--------. <br /> <br />SQUARE FOOTAGE _..________ HElJI1HT ...____.___.____ <br /> <br />IlEJSCRIP'nON OF NORK <br /> <br />~----------_.._._-~......... <br /> <br />RIll8IDElNTI1\J'1 <br />(~m1MBlRC!I1\I, I <br /> <br />A'I"rACH (:2) PL,OT PI"Al1S & (2) SElTS OF BUlI ,DINrl PI,ANS & (1) SElT ElHElRI1Y FORMS, <br />A'r'l;ACH (:3) SETS OF Butl,DING PLANS & (1) SET ENERCW FORMS, <br />PROPERTY SURVEY REJQUIRED FOR ALL NEW CONS'I'RUCTION. <br /> <br />~ERMITS RWQUESTED <br /> <br /> <br />t.__________._._ VAl,tJATJON OF TOTAL COHS'rRUCTION <br />2-:0.0.______ MtlP ~IllRVICEJ ~rnA PONER [J W.R,El,Cl. <br /> <br />[] PWt1BING <br />U 1.1B:CHl\.N WAI, <br /> <br />$--_.~ <br /> <br />- VAlJUATION OF ttlECIIANCIAL, UIS'rAl,I.ATTON <br /> <br />[] GA8 <br /> <br />f.J ROOFING <br /> <br />LJ SI?EC!tAUrY <br /> <br />[] O'l'HER <br /> <br />TYPE: OP' CON8TRtJCTlOH I [J BLOCK <br /> <br />[J FRAt1EJ <br /> <br />[] STEEl, <br /> <br />[] OTHEJR <br /> <br />F'rN ISHElII FI,OOR mIJEVl,TIONS <br /> <br />IS PRO,TECT IN FLOOD ZONE! AREA 0 YElS <br /> <br />o No <br /> <br /> <br />BUILomR <br /> <br />. - <br />_._-_.._-'~-_._-----~---_.------------_. ----_.- <br /> <br />CottlPANY__________...____________..._..___.___ _._.__.____._ ___ <br />STATE CElRT OR REGIS'!' # ._."._______._.____.___,,__,__~_.___ <br />CITY PROCESSING # <br />----.- ~ ...._--~ - '-..-...--..,-.--~-._...___..". .' 40__..___ .,__ <br /> <br />91GNATtJREl <br /> <br /> <br />***** ~ ***** *** ***** * ******* * ~ ~*** *** * *** ~ * * * ******* **** ** * **** ** * * <br /> <br /> <br />COl'1PANY _.1-( ;;f2f_~(q.2_?_Eft~,-:~~_ _. _... <br /> <br />.-- - <br />STATE ('ERT OR RE:rnS'l' #_._~.g 0:.:.z<2~_??t? <br />CITY PROc.'ESSINrl #jf, <br /> <br />..---.-.-__._L_ID_.._. _~ _._. __ ______..~._~._._. <br /> <br />***********~* * ***~********~************************************ <br /> <br />P I,UM! B1R C!O!vl P ANY -----.-----------.,....-----..------.h__.__.___n._.__ ______ <br />STATE CERT OR REGIST # ________..____._.__.._.___.. <br />8WNA'l'IJRE CITY PROCESSING # <br /> <br />-.--...-.- _._-~-_._---------._-----_. -.-.--""-- <br /> <br />**********'***'**************************************************' <br />MBlC!HANICAT. COMPANY ____________..__.._________ _.._._____.___. <br />STATE C'ERT OR REG t ST #-~-_.___.h____n____________n_. <br />SIGNATURE CITY PROCESSING # <br /> <br />----~------__..__._4____._~...._~.____._ __~___.._____..__._____ '_.___.__~_~ <br /> <br />*****************'********************~*****************A******** <br /> <br />OTHER <br /> <br />--------_.,---...._--_._~--._--~.- <br /> <br />CO/:lPANY <br />STATE CBlRT OR RElGrST # <br />CITY PROCESSING # <br /> <br />.~_.---_.._--..;~----------------------- <br /> <br />8 WNA'l'UREJ <br /> <br />****************************************x*******************'**** <br /> <br />.--..------. -- ..... _.._--------.._~._._-- - -.-._--_.... ....-- <br />