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<br />CITY OF ZEPHYRHILLS PERMJ.T APPLICATION <br />:aUIl,DIN<1 IlBJI?ARTMEN'l' 5335 8th S'rRBlIlI'l' ZBlPHYRHII,I,S, P'L 33540 <br />I?honeI813-780-~020 FaxI813-780-0021 <br />DATBl RIll<JIIlIVJllD -1_~_ !.]~~_~_l__ <br />I?J,ANB RBlVImW 1'811I_,-___:: <br /> <br />-- AfJ -/1 1. _ Y _tJ? <br />.(J;J.JU.-(X /t.f <br /> <br />O\'iNEJR I 8 HAJI1B]_.___.___.__~~_-\\.,., o..--Cr~.c~c'~______ _____ PHONE CON'l'Ar~'~'____~_ __ ____'_""_'___ <br />,JOB SITE ADlJRBJ88~~Lb_QJ.._$~_~'~~~__~~i_:("_~'~\\~_r_ ~L-L_h'_____~__'_ __._._u <br /> <br />LBlf.mL DH1S(!RIPTIOll: LOT(S) <br /> <br />BLO(~K <br /> <br />SUBlJIVIS]Ot! <br /> <br />PARCEll, ID II <br /> <br />HURK PROPSBltJ I [J HEH t'ONSTRUCTION <br /> <br />-----.-----.-~~.___4.___ ________.._.__._._______.___.~___._._ _____..___._._____.__~_______..__. ..__.._ ..___________..._. <br /> <br />(UBTAIN FROM PROPElR'l'Y 'PAX NOTICE) <br /> <br />[J 8 rrm <br /> <br />[] ADDITION o AI/I'ElRATION (] REPAIR [J INSTAl,!, <br />o MOVE 0 DElfJlOt,ISlI <br />[lr1tJw'r -. FAtvJI1.Y [J# OF UNITS [] IvJO a II. Rl lIor1E <br />fJ rNDUSTRIAr~ [J SHH1MIWJ POOL U OTHBlR <br /> <br />PROPUSEIl USE: I []sm~ FAMILY DWElJIII11Gl <br />[~MBlR(! 1A r, <br /> <br />IlESCRIPTION OF HORK <br /> <br />C::J RBI8TAlJRAN'l' & HBlAl/l'H DEJPARTr.1ElNT APPROVAL <br /> <br />JlfLmo-l-~!Lrr--{;dL~-&9L<i,~__~~~<;L..,.:;~~,,:L0,'0~ <br />SQUAREl FOOTAGE IIElIGHT <br /> <br />BUILfJIN{] SIZE <br /> <br />~~----------. ------- <br /> <br />RE8IDElNTIAT, : <br />Cm1MEJR(!IAI, : <br /> <br />A'I"l'ACH (2) PLOT PI~AllS & (2) SElTS OF BUIr ,DINC~ PLANS & (1) BEl'l' E1NElRnV F()R~1S, <br />A'r'l'ACH (3) SE1nl OF BUII.!JING PLANS & (1) SET ENERC1V FORMS, <br />PROPBiRTY SURVElY REQUIRElIJ FOR ALL NEW COHS1'RUCTION. <br /> <br />[1 ElLElC'I'RlCAII <br /> <br />-------_____-'- AttlP ~ElRVICEl <br /> <br />o Ff.r.1RIDA POWBlR <br /> <br /> <br />[~I.JINf~ <br /> <br />~ERMITS REQUESTED <br /> <br />L1.3~oQ--,-OQ__ VALUATION OF TOTAL COHS'f1HlCTION <br /> <br />[J <br /> <br />[] PWttlB ING <br />o 1,1EJCHAN TC!AJJ <br /> <br />TYPE OF' CONSTRUCTION I [J BLOCK <br /> <br />[] FRAltlEJ <br /> <br />[J STEEl!, <br /> <br />[] OTHER <br /> <br />If: e) <br />U l\; <br />d-C\ <br /> <br />/~L\ 1 <br />'J <br /> <br />$...._ <br /> <br />-----.-- VAI,UATION OF rtlECIlANCIAI, UISTAI,IJA'l'TON <br /> <br />[] GA8 <br /> <br />U ROOFING <br /> <br />[0] SPE]CJtAUl'Y <br /> <br />[] OTHER <br /> <br />FIN lSHEll1 FI.OOR Elf,E]VATION8 <br /> <br />IS PROlTEC'f' IN FLOOD ZONE AREA[J YES <br /> <br />o No <br /> <br /> <br />STmTA'I'UREJ ____ <br /> <br />('Of1PANY -_ Co_Q<'Q d_~~I1\Qr :0.(1 '>_Ei_.s...-X.-:?~.._ <br />STJ\TEJ CEJR'l' OR REGIS.h # .-.-<::".6:J:'",_A::: _LQ9..s:.~___ <br /> <br />---i:. 0,' _ ,i(",;~---~,,\="- CITY I?IWCE1SSING tt_~~____._ '-lfiXiiQ -Y_q <br /> <br />""" · m-\" ". ",p."""". "."". .."."....".. ....... ,q flk <br /> <br />CO!-1PAN '{ _~'_____ ._.._~______~__.___.____.____..__Q____ <br />STATE CElRT OR RE~T8T # <br />.-----.... .--.-------------~-------- -------.- CI'I'Y PROCESS IN(~ # <br /> <br />._--_..__.__.__._.~--_._.-.~--~_..__..__..~_. _. -.- <br /> <br />mf,mCTRICIAH <br /> <br />**************************************************************'*** <br /> <br />._-~--'-'-'- ~_. .-.--------........... - ~-_..._-. ---------.- <br /> <br />P I~t1MB B1R (~OM I? ANY ___h_.._________._____ _____._________. "___'__" .___..___.____..__ <br />STATE CERT OR REJ8IST # _________._________..___.___. <br />SWNA'l'lJREJ CI'I'Y PROCESSING # <br /> <br />..'"--.--. ~_._~-...._-........_--~ _._-----_.__._---_._--~---- ---_.._~ ,,".- -- .~---_._--_.-.- ..._--..__._----_._~- <br /> <br />****************************************************************** <br /> <br />MBlc!HANI CAl, COI\1PANY-_________._h_.__________. ___'__'_ ___.. <br />STATE r'E1RT OR REGI8T # -~---.-..-..-~--__.___.._h____._ <br />8 TGNA'I'lJRE Cl1'Y PROCESS ING # <br /> <br />.-....-.-._--_.~---~.._---_._---_.__..__._--_...._--_.._---- _.-~---._----------_.-.-_.- -.- -~-'---_. <br /> <br />*'************""'*'**"*"**"'**""*"'*"'**"**'"******'** <br /> <br />o'rUBlR <br /> <br />SWHA'l'lJRE1 <br /> <br />COrv!PANY <br />S1'A1'El CEJRT- OR - REl(HST -ij--------------------...--.-.-.---..--.-- <br />Cl'rY PROCElSSING # -.-----Uh.______.h_____H <br /> <br />---.-.------.-...-------..--------.------ <br /> <br />***'************************************************************* <br /> <br />~--_. --.. -- --_..._._-----._--<-----.~. "-.'-.-.., -~'.- <br />