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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 /> <br />) jAn/l-S IAh t?A-~7 <br />56'33 ) 11) 577 ~~j~h' 15- <br />LEGAL DESCRIPTION: LO!(S) 17+/~ BLOCK /()6 SUBDIVISION <br />~ 11-;J6-21-0())O -/0600-01?O <br /> <br />JOB ADDRESS <br /> <br />PHONE RH-;J;77-;??/'? <br />fi, 3.3JY 2... <br /> <br />OWNER'S NAME <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION o ADDITION OALTERATION o REPAIR o INSTALL <br /> o SIGN o MOVE 0 DEMOLISH 51/~ , <br />PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />CJ RESTAURANT <br />DESCRIPTION OF WORK IIIIZiIC //I1JV&.. <br />/ <br />I() I Y I ~ I <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />A-lfl"'I!VVt'7 f/rp-6l1J iT 5Ad <br />J~(} I <br /> <br />HEIGHT <br /> <br />7' 61( <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />o BUILDING <br /> <br />-:? <br /> <br />()r7 <br />I (JOO" <br />I <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br /> <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 /> <br />BUILDER / fLLr COMPANY _,:_ 5~L;:- <br /> <br />/7' 'L/~ STATE CERT OR REGIST # <br /> <br />SIGNATURE __/ U~W<",. CITY PROCESSING # <br /> <br />:Jj'.A/!:1~ * * M * * ?f-tnv~ * * * * * * * * * * * * * * * *' * * * * * * * * * * * * , * * * * * * * * * <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 />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />