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<br />f ~" ,~,-( (. D /., Ii:- <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED ~-/.3-D~ <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME !r-oL 0 fVl0LJ fJ. C:-'- (' tJ r ft J /l1 ~ 5 PHONE Y'/3 - } c? /- ~..2:) ? <br /> <br />1:'; 03S~ :2i~j'a4?' (k, <br />~ -'1 iJ"J €. <br />LEGAL DESCRIPTION: LOT (S) iff BLOCK SUBDIVISIONS/L V(l~ ofi,< 5 V;<-c.. /-/t.rf. o'-'E <br />PARCEL ID # 03 -~~-d 1- o~co- ~o - Dl/-~D (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />JOB ADDRESS <br /> <br />A<JT <br /> <br />WORK PROPSED: ~ CONSTRUCTION o ADDI'rION o ALT E RAT I ON o REPAIR o INS'fALL <br /> Os I GN o MOVE 0 DEMOLISH <br />PROPOSED USE: ~ FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />.u~ (y <br /> <br />5/r-/.. c.~ ~ /J/Vl/ c::.7 <br />SQUARE FOOTAGE ~:'b i' <br /> <br />HEIGHT <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT <br />ATTACH (3) SETS <br />PROPERTY SURVEY <br />\ <br />\ <br /> <br />PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY <br />OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />REQUIRED FOR ALL NEW CONSTRUCTION: ~ <br /> <br />7/d <br />PERMITS REQUESTED ____ c <br /> <br />FORMS. <br /> <br />!3"i3UILDING <br />I:WELEcTRICAL <br />~LUMBING <br />~ECHANICAL <br /> <br />t1J~ rk <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />::iCrU <br /> <br />AMP SERVICE <br /> <br />~LORIDA POWER <br /> <br />o W.R.E,c. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br />~RAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />~O <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />COMPANY {r- v '-'12 fVl e iJ 19 <..<:.../ a I-' H J "1. €.. J <br /> <br />STATE CERT OR REGIST # <br />CITY PROCESSING 1t 10 Cf <br /> <br />SIGNATURE <br /> <br />* ** ****** -1.,** ** * *** **** **** ********************** ******* *** / <br /> <br />Ft'-5>t C 1ft ~5 E( r~ (</:( <br />COMPANY <br />STATE CERT OR REGIST 1t P -aJi).<'!J?() <br />CITY PROCESSING 1t <br /> <br />PLUMBER <br /> <br />'**************************~*it~**~~~~;***fi~~~b~ <br />COMPANY / / ~ -' ~ i, <br />STATE CERT OR REGIS'.!; ,1t' f- ,,{JJ -6 <br />CITY PROCESSING 1t I b6 <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST <br />CITY PROCESSING 1t <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***************************************************************** <br />