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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 <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />OWNE:R' 8 NAME: K.d:H..,leet.J LClc;.k~"'J <br />,JOB ADDRESS. 3Y~4(' ILl"''' A~r:: <br /> <br />PHONE SrI"3 -""-:!:6P(' <br /> <br />LEGAL DE:SCRIPTION: LOT(8) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # ll-J.(r ;)./-00/0- O~30Q - O~~ I <br /> <br />lDBTAIN FROM PROPER~Y-TAX NOTICE) <br /> <br />WORK PROPSE[): DNEW CONSTRUCTION <br /> <br />o ADDlTIOtl <br /> <br />o ALTERATTON <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br /> <br />o t-10VE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: ~SGL FAt1TLY DWELLING <br /> <br />o <br />COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWH1tlING POOL <br /> <br />o t10BILE HOME <br />o OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTt-1Et'lT APPROVAL <br /> <br />DESCRIPTION OF WORK (l't!.-tl.oo,*, ~"Io.(jlt!!. fJAI teub&-t'..L ~#'t;1';,""'AJ-C <br />I <br />BUILDING SIZE SQUARE FOOTAGE /753 HEIGH'!' <br /> <br />RESIDENTIAL: <br />COI'11'1ERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDH1G PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COllSTRUCTION. <br /> <br />0 BUILDING <br />0 ELECTRICAL <br />0 PLUMBING <br />0 MECHANICAL <br /> <br />$ (, ISO ~ <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />Al'1P SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R,E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />[j ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF' COllSTRUCTION: II BLOCK <br /> <br />o FRAt1E <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FItIISHE:D E'I.OOR ELEVATlONS <br /> <br />I S PROJECT III FLOOD ZONE AREA 0 YES <br /> <br />o NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGtlATURE <br /> <br />**~**+******************~*********************+*********~,********* <br /> <br />ELECTRICIAN <br /> <br />SIGIIATURE <br /> <br />C0l1PAllY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />*************k**************************************************** <br /> <br />PLUMBER <br /> <br />COt1PANY <br />STATE CERT OR REGIST ff <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />MECHA,NICAL <br /> <br />****************************************************************** <br /> <br />f.:Ot1PANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />************************~~****************************A*********** <br /> <br />OTHER (3/'iA-,J ,S-I-dvle,t.. - tlooC.. ~ <br />SIGNATURE ~-:JP tv~ <br /> <br />COt1PAIlY I.,,vv,iVc""e ,4~ot! LIJe... <br />STATE CERT OR REGIST # _C~CD,:!qJ(,).. <br />CITY PROCESSH1G # <br /> <br />************************************************~*****~***~~~***** <br />