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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUII,DING DIllI?AR'I'MElN'f 5335 8th S'fRIllIll'f ZIllPHYRHII,LS, FL 33540.
<br />PhoneI81]-780-~020 Fa~1813-780~0021
<br />tJJ\.'n RIll<1111IVlllD ~~_ ".~ .~"~
<br />PI,AUS RlIlVImw I'BlB_'-_'-n._..U ___ .
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<br />UWNmR'. NAMO --Gcid. (',N__.~J~- ~-~_Lg€S T *l"'o:.ANJ:~___ P"ONO mm'^,,'U:' L~~ 15:1': ?~o
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<br />.J08 SI'I'B1 ADDRESS _____~_~ .5~_:>-=- --~.fr1~----~L~~---~~-'P=h~\~1_fl---________
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<br />IJBlGAL D81sc.!R I p'nON I LO'r (S)
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<br />PARCEll, I [l #
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<br />---..--..- ----------
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<br />BLOC!K
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<br />---'-.-.-
<br />
<br />SUBDIVISION
<br />
<br />_._----~..--~-.. .-.--.....---- .-..-.-............--
<br />
<br />HURl< PROPSElrJ t [~N C'ONs'rRtJCT ION
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<br />--------_._----------_._--------~-------------------------------- ---------------------.--
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<br />[)SHm
<br />
<br />o JWIJITION [] ALTERATION [) RElPAIR U TN8TAr,l,
<br />[J MOVE: [] D1:!lrIJO 1, I S II
<br />[h1lJ!,'I'r -. FAf-.1n,y 0# OF tJN !'I'S IJ MOBIl,El IInl1Bl
<br />[J INDUSTRIAL fJ SwnilMING POUL fJ O'mER
<br />
<br />(OBTAIN FROM PROPERTY 'I'1\){ NOl'IC~m)
<br />
<br />I?R<)t.>OSElIJ USE I []SGJI, FAMILY DWEll,I4INGl
<br />
<br />[J C0/1MEJRc! JAr,
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<br />CJ R~:8TAlJRANT & HElAlml DHlPAR'H1ElNT APPROVAL
<br />"0. eR IP'l' ION () F "OR K .. ':r::" ,,{ ,,\\ ,,+ , ",~__q{ 0. I t ~I:.<j A, .TIC'. "'--2J,l'..fE ""-..~.~.
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<br />Bl1ILDIN(] SIZIll
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<br />---_._---._--~----
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<br />SQUARE FOOTAGE
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<br />-h,____u. ".-'_..__
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<br />REBII1BlNTIAl, I
<br />(~OMMBlIWIArJ I
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<br />A'I"rACH (2) PIlOT pr4AllS & (2) SETS OF BtJIr,DIN(l PLANS & (1) BElT ElNElRGY FORMS,
<br />A'r'J'AC!H (.3) BE'rs OF BUnDING PLANS & (1) SElT ElNEllWY FORMS,
<br />PROPERTY SURVEY RElQUIRElD FOR ALL NEW CONSTRUCTION_
<br />
<br />--- ---------------
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<br />HElJGHT
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<br />._----._--~--------
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<br />tJ B tJ Ir,1JI Nf~
<br />IJ BlLIlICTRlCAI,
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<br />FmRMITS REQUESTED
<br />
<br />$ ----
<br />
<br />VALUATION OF TOTAL CONs'rRUCTION
<br />
<br />--------
<br />
<br />AMP SElRVICEl
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<br />o
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<br />FLORIDA POWER
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<br />WoR,Ill,C},
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<br />[] PI,UMB INC~
<br />U I-1ElUHANlt!AT,
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<br />$-------
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<br />- VALUATION OF MECHANCIAI, IHSTALI,ATTON
<br />
<br />[J (JAB
<br />
<br />L] ROOFING
<br />
<br />fJ S PECI Al!l'Y
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<br />[J OTHER
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<br />'l'YPBl op' (X.lN8TRuc'rION I [J BI,OCK
<br />
<br />[1 FRAMEJ
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<br />[) S'I'EI!JL
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<br />[) OTIIER
<br />
<br />FINISHErJ FLOOR mr,ElVl<iTIONS
<br />
<br />-------
<br />
<br />18 PRO_TEe'I' IN FLOOD ZONE] AREA 0 YElS
<br />
<br />o NO
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<br />!HtILIJIlIR
<br />
<br />mr,BlO'1'RICIAN
<br />
<br />******************************************************************
<br />
<br />('Ot-1 PAN Y ----.--------.--.---__________.. _____.. ___. .__. .. _ _______ ___ _ h__ _
<br />STA'I'El CElRT OR REJ8IST # ___________________._______
<br />CITY PROCESSING IL_..______________________ ....__________ ___
<br />
<br />81GNATURBJ
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<br />---.,-_._.---.""-~---=-.;...-_.._...:..-----=--------..-------_.._._---
<br />
<br />C0/'1PAN Y __________~_________..___. ____..____. _______
<br />STATE CERT OR RI!JGTST #
<br />S WI TA'l'IJREJ ---------.-----------__________________ C!TY PROCESS IN(~ #
<br />
<br />*********************,************.****************************'**
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<br />._~-- ..._._-_._-~_....~-'-------------,.- -.... '..-
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<br />-----._---~--_.._-.__. --.-..- .._---.-....._-+~---
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<br />----.-----
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<br />< JOMPAlIY ___________~--__.______..____. ____.________
<br />
<br />STATEl CER'l' OR REGIST # _______________..____...
<br />CITY PROCES8IN8 #
<br />
<br />SIC1HAT17REl
<br />
<br />MBl(mANICA1,
<br />
<br />******************************************************************
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<br />-'-'- ----0_'0- ____._______ _..>_.__________~_
<br />
<br />_.__.._~------.__._-
<br />
<br />C01VJPANY _________________________._______
<br />STATE ('ElRT OR REGIS'r # ~-.---------------___u_
<br />CI'l'Y PROCESSIN8 #
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<br />SWNA'riJREl
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<br />OTH.. "o"p ANY -=1 ROf? l~ '" L L ,,~cl.~.<:."i'.E:_'I)_~~rm <
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<br />*******************************************************'***~*****
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<br />**************************************~****************'*********
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