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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5~35 8th Street, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED ~-.:30 -O~ <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME <br /> <br />&I'-~~ j( CJ{l. (-",:/\1 <br /> <br />PHONE <br /> <br />JOB ADDRES S L... 7 { '2- 1 J 7"2. 0 <br /> <br />J.. 0 ~ -( "" ..q <br /> <br />/Jv-<- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />fr~J tfc.~;'-Z"'~':' <br /> <br />PARCEL ID # <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULT I - FAMIL Y <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />'EtMOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />Mrrt <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />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 />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />--------~ <br />~ ---/~ ) <br />~ <br /> <br />PERMITS REQUESTED <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 />$ <br /> <br />VALUATION 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 FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />BUILDER <br />SIGNATURE LJ~ ~ <br /> <br />COMPANY B.I~ <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />w~~ <br /> <br />COMPANY /1 c.. ~ <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />h/~~ <br /> <br />COMPANY /?<~ <br />STATE CERT OR EGIST # <br />CITY PROCESSING # <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br />COMPANY )1 c.. ~ <br />W <>. -d'7~ /-M STATE CERT OR REGIST # <br />~ CITY PROCESSING # <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />