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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8~ Street, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED g-~t)3 <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME CI-ry OF ZEPI-IY/2HILLS <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />53'38 $EVe:NTf/ S-r: <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />i 1- 2.6 -21 - 0010 -/3400 -02-00 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br />~ DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERC IAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />CoMPLE...iF:.. 1/E:MOl I-rJO/V/}i'" ~/NG,L-;::";'PAM/LY ~6:5Il:E:NC;P: <br /> <br />BUILDING SIZE <br /> <br />/ <br /> <br /><;ro12'/ <br /> <br />SQUARE FOOTAGE 32.88 <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT <br />ATTACH (3) SETS <br />PROPERTY SURVEY <br /> <br />o BUILDING <br /> <br />$ <br /> <br />PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />1JJ~ <br />PERMITS REQUESTED ~ <br />VALUATION OF TOTAL CONSTRU~~ /_---- <br />. t-~"-l <br />.p) '3 I !F <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />FLORIDA POWER <br /> <br />o <br /> <br /> <br /> <br />o ELECTRICAL <br /> <br />o PLUMBING <br />o Iv1ECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLA' ON <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 />SIGNATURE <br /> <br />~ t a:;( <br /> <br />COMPANY CROSS {);/Vsr,e.uc 71 ON <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />Co, IN~. <br />, <br /> <br />BUILDER <br /> <br />********************************************************~.********* <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <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 />********************************************************'k******** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />********************************************************+******** <br />