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<br />O~INER' S llAl'1El / () LlO A.f?.cJ,..v PHONE (10N'l'AC!'r_________ __...__.__
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<br />,JOB 8 II'B 'DlJ~;;;~r~:: ..9i~:;;.;!~=;~~~--"';;,~--2 7C,O'f2!..,~tf-""(~~__
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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUILDING nE~ARTMmNT 5335 8th STREET ZEPHYRHILLS, FL 33e40
<br />PhoneI813-780-~020 Fa~1813-7eO-0021
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<br />PIJANS RBlVIBlW J'IllBl
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<br />LE1flAL DESUR 1 P'fIotl: LOT (S)
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<br />(OBTAIN F'ROM PROPElR'I'Y 'I'1\K NO'l'Wm)
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<br />~WRK PROPSEllJ I [jNBlN C'ONS'I'RtlCTION
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<br />[] 1\rm I'r ION (J 1\LTERATIOH [] REPAIR LI INSTAl,!,
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<br />PR<)l.lOSEJI1 USE: I [Jsr]!J FAtULY DWElLrJIH(~
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<br />IJE8CRIP'l'ION OF HORK
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<br />o R~18TA[JRANT & HElAI,TII DElPARTt-1ElNT APPROVAL
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<br />BUU,HINll SIZE
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<br />SQUARE FOOTAGE
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<br />A'I"1'1\CII (2) Pl,(YI' prJA1l8 & (2) SETS OF BtJIJ,[HNlJ Pl.ANS & (1.) SElT E1NI!JRr~y FORMS,
<br />A'!"liACH (3) SHi'l'S OF 8UtLI11NG PLANS & (1.) SEl'l' ENElFWY FORr1S.
<br />PROPERTY SURVElY REQUIRED FOR ALL NEW CONS'I'RUCTION.
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<br />pmRMITS REQUESTED
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<br />VALUATION OF TOTAL CONSTROC'I'ION
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<br />- VALUATION OF f-1ECHANCIAr, HIS'I'AI.LA'I'TON
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<br />'l'YPHl OP' CONSTRUCTION I [J BLOCK
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<br />FINISHEJ/J Fr,c)OR BlIJEVTiTIONS
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<br />IS PROlfElC'I' IN FLOOD ZONE! AREA [] yms
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<br />aUIfJ081R C'of-1PANY _.___._______...__.___..._____.______.._
<br />STATE CEJR'I' OR RElGIS'I' ## ____~__..__.____________.__.___
<br />B lGNATtJ. 0 -~-x--~~___,_,.,.___ CITY PRO"E88ING Il--f{/---.-,-,-,-- ,__,.,,_____
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<br />******************************************************************
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<br />B11.BlCTRICIAlf CDl'1PANY _..L1~~:..______~________._.____,_._ _m.___
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<br />MBlClHANI CAr,
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<br />C~(JMP1\N Y ---.J!}~ _____.___.____.______________._
<br />STATE: CE:RT OR REJGIST # ___.__.______.______.
<br />SIGHA'1'I1Rg. --'--_k:!.,~~~..________ CITY PROCEl88ING ## _..__.._.._________.________~_____
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<br />COlVi PAN Y -----Lf_c:::.:'5:=______.______________________._.__
<br />STATE CERT OR REGI8T #
<br />8WN"!'1l'" __~~~___ CITY PROCB.8ING #_~~='=',=-~~~,.~=-'-,-
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<br />Cor.1PANY
<br />8'1'1\ '1'HJ ciiiRT OR RE~~---------u_----, -,-
<br />CITY PROCESSING # -----.--__.._________
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