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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8~ Street, Zephyrhills, FL 33542 <br />-13-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED ~- il!3-~ <br />PLANS REVIEW FEE <br /> <br />LEGl\1 ~S( <br /> <br />cm-ll /J1((JJ <br />~'5~ <br />tf: ' t$- tJ () v f2- <br />'~~tO) IWE- <br /> <br />OWNER' S I <br /> <br />PHONE #1 ~ - 7r2 - I DCo If <br /> <br />JOB ADI:t:: <br /> <br />l-oT <br /> <br />t3Lf <br /> <br />SUBDIVISION (Pm-IV?? HIJ(l.{ ZO;V /Y1 flf. <br /> <br />BLOCK <br /> <br />PARE"ID # '3l.f- z.. C;; - 21- {JOt 0 - 02 if f)O", 0 (J 'f <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />~,K !ROPSED: ~W CONSTRUCTION <br />o SIGN <br /> <br />PROPOSED USEY~ FAMILY DWELLING <br />OCOMMERCIAL <br /> <br />~DITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />~TALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />Er:: ,(J L VM , 1I/v'1lo^- <br />OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RES~NT & HEALTH DEPARTMENT AP~ <br />I'1X (.;- S"L~V fld,f/l/L, I L)\ 4 f" tJ>. (l PO{L.I +- S IIf/) <br />I <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />7 ~(p <br /> <br /> <br />", <br /> <br />',,- <br /> <br />PERMITS REQUESTED <br /> <br />S:;;~Y FORMS.\, <br /> <br />~tU <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION, <br /> <br />~UILDING <br /> <br />$ <br /> <br />, Lf (r-r3. <f 2..-- <br /> <br />VALUATION OF TOTAL CONSTRUCTION ",-_________/ <br /> <br />GJ ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br /> <br />.._\ <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 />..".".....,,~"'" ........,..,:"V'.-'1'.,.~-~ l"'"~ ..,......,..-,.,.."" ~ ~~"""'1r~1"""'---'-""''''''''' <br />~;I,~\~,11'lk.r'{" I, t,,):i rt:,!. jPI'~;) ~ <br />\ r r ... 'j 'i ' ! <br />.......-...._~..................J.__......._.~......~___...~__~___......ol..._____...... ... <br /> <br /> <br />BUILDER <br />SIGNATURE _~ jJ. a1~ <br /> <br />COMPANY S ~ H C 01\/ 5 rlb.x..- T 10 f./ 0/:::- CtSNr(44L [:L, <br />STATE CERT OR REGIST # {BCD &::7'7 1'7- <br />CITY PROCESSING # "J-.I.o <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br />" <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />