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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />aUILDING DEPAR1~NT 5335 8~h Street, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECE IVED <br />PLANS REVIEW FEE <br /> <br />OWNEfti S Nl\ME ~ ~ LlIlI~;\.~+('J J/lC- <br /> <br />,JOB ADDRESS S(.;,to C:, f /., 5+' <br /> <br />PHONE Iff) 1?:J -002' <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />11- <. rO- <"1- 0 d 0:5>006 -OJ g-O <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />OS1G[,1 <br /> <br />PROPOSED USE: OSGL Fl\MILY DWELLING <br />~~1MERCIAL <br /> <br />o ADDITION OALTERATION o REPAIR 4hISTl\LL <br />o 110VE 0 DEMOLISH <br />Ot.1ULTI - FAt1IL Y 0# OF UNITS o t10BILE HOME <br />o INDUSTRIAL o SWIMtlING POOL o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTt1ENT APPROVAL <br />f(/\c<- <br /> <br />L{,tJ .~....~ <br />5QP7\RE FOOTAGE <br /> <br />22..3 ( <br /> <br />HEIGHT <br /> <br />b ( <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />l\TTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (l) SET ENERGY FORMS. <br />ATTl\CH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />o BUILDING <br /> <br />$ <br /> <br />~ <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICl\L <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o vLR.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />Vl\LUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAt1E <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISIIIW FLoOR ELEVATIONS <br /> <br />IS PROJE:CT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />******~*******************~***********~*************************** <br /> <br />ELECTRICIJ\N <br /> <br />SIGNATURE <br /> <br />COHPAtly <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGtlATfJRF. <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />C0l1PANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />**~************************************************************** <br /> <br />OTHER <br /> <br />SIGNATURE; <br /> <br />COtvlPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />******************************+***************************'******* <br />