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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 />, . <br />OWtJER' 8 NAt~E _j)I2(~ rpuo {)~~Il1t5" {)U/fl/t~/2.s <br /> <br />JOB AD[)RESS_~ 7&0 f.lo~t:V L- ( <br />/ <br />LEGAL DESCRIPTION: LOT(8) BLOCK <br /> <br />It SStJ C PHONE <br />=--.; <br /> <br />SUBDIVISIOH <br /> <br />PARCEL ID # <br /> <br />(QETAIN FROM PROPER~Y-TAX NOTICE) <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITIOtl <br /> <br />o ALTERATION <br /> <br />~PAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o t"lOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FN1TLY DWELLING <br /> <br />o <br />COMl1ERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UIHTS <br />o SWH1MING POOL <br /> <br />o 110BTLE lIot"lE <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAUR,ANT <br />k- ~ l2oOh,v c/ <br /> <br />I <br /> <br />& HEALTH DEPARTl'1ENT APPROVAL <br /> <br />90/ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE ____ <br /> <br />HEIGH'!' <br /> <br />RESIDENTIAL: <br />COMt1ERC IAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUTLDU1G PLANS & (1) SET ENERGY FORMS, <br />I\TTACI! (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CotlSTRUCTION. <br /> <br />0 BUILDING <br />0 ELECTRICAL <br />0 PLtJt"lBING <br />0 MECHAtlICAL <br /> <br />$~.XOO <br />/ <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W,R,E.C. <br /> <br />$ <br /> <br />VALUATION OF NECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />~OFING <br /> <br />o SPEcr ALTY <br /> <br />o OTHER <br /> <br />TYPE OF' CotlSTRUCTION: 0 BLOCK <br /> <br />o FRAt1E <br /> <br />o STEEL <br /> <br />o CYPHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />I S PROJECT HI FLOOD ZOlm ARE~A 0 YES <br /> <br />o NO <br /> <br /> <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSIt~G #_ <br /> <br />SIGNATURE <br /> <br />************************}***************************************** <br /> <br />ELECTRICIAN <br /> <br />cm1PAlIY <br />STATE CERT OR REGIST # <br />tlTY PROCESSING # <br /> <br />S I GllATURE <br /> <br />********************************~.********************************* <br /> <br />PLUMBER <br /> <br />Cm1PANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />*****************~******-~****************************A*********** <br /> <br /> <br />-lelr ?/lJ (10 <br />SIGNl-\TURE --It t/... ~ <br /> <br />cm'lPANY (!lfc//~ /2t'fh~Y <br />STATE CERT OR REGIST # /Lc..-oo'f~z-,,(( <br />CITY PROCESSING # lIt <br /> <br />, <br /> <br />**~***************************~***********************~***~****** <br />