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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 RECE IVED <br />PLANS REVIEW FEE <br /> <br />JOB ADDRESS <br /> <br />{.:'lft( C-/{ <br />S-SJ.. '} <br />, <br /> <br />LitO iUc?-L- <br />2Lj yt 57 <br /> <br />PilotTE <br /> <br />ownER' s ~lAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL If) # <br /> <br />WORK PROPSED: Ol'lEW CONSTRUCTION <br /> <br />o ADDlTIOt'l <br /> <br />(~AIN FROM PROPER~Y-TAX NOTICE) <br />o ALTERATION ~PAIR 0 H1STALL <br /> <br />OSIGtl <br />PROPOSED USE: ~L E'AMILY DWELLING <br /> <br />o [,-10VE <br /> <br />o DEMOLISH <br /> <br />o <br />COMt1ERCIAL <br /> <br />OMULTI-FAI-1ILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMtlING POOL <br /> <br />o t10BILE HOME <br />OOTIlER <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTt1ENT APPROVAL <br />to <br />IL~ Looh#t- J r i <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 BUILDltlG PLANS & (1) SET FNERGY F'ORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW conSTRUCTIon, <br /> <br />0 BUILDING <br />0 ELECTRICAl, <br />0 PLUMBING <br />0 MECHANICAL <br /> <br />~YOO <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP 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 />~)OFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF' COllSTRUCTION: II BLOCK <br /> <br />o FRAt'1E <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FItIlSHED FLOOR ELEIJATJO!1S <br /> <br />IS PRO,JECT IN FLOOD ZONE ARE:AO 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 />************************k************************kk**********~**** <br /> <br />ELECTRICIAN <br /> <br />COt'1PAllY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />Cm1PANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />cm1PAlW <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />*****************************************************A*********** <br /> <br />~ " <br /> <br />Cm1PANY {-/Ie/IN ~tOt7hN~ <br />STATE CERT OR REG] ST # IZL OtJ f6~1( / <br />CITY PROCESSING # -.l16 ^ ___________ <br /> <br />OTHER ~?II-J/~ <br />S I GNl\ T [J RE ~__ t----:--' <br /> <br />***********~******************~*****k****~*******k********~~**~** <br />