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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8th Street, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 ~ -,;21-()~ <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />JOB ADDRESS <br /> <br />~oll <br />1 ~/c.{~ <br /> <br />Q;'7e <br />1::" /Juf <br /> <br />PHONE <br /> <br />7/5 . CJ19v <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # --1l - 2. (,- l' - 001 0 ~ \ '7b 0'- 011,.0 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />DCOMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~ /c CJ~\~(? o~f- <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />~OOcJ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W,R,E,C, <br /> <br />o PLUMBING <br />o MECHANICAL $ <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />(f~ <br /> <br /> <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 /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES . 0 NO <br /> <br /> <br /> <br />SIGNATURE <br /> <br />COMPANY~ (( --.... <br />~ .i' (~ STATE CER'f OR REGIST I <br />i.. CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />p/*******f..*****~~"""""""""'~~~;:~~"'~~~.:'......... <br />~ STATE CERT OR REGIST <br />~ CITY PROCESSING # <br />r / <br />***************************************************************** <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />