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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />. BUILDtNG DEPARTMENT <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME 1Y}f'J:O/)Y\_,- ~~_ f7bi/5f-j My /:Jet:)!) Iile-, PHONE <br />JOB ADDRESS ~i1(Yi 1'f1L c5f-r~ , <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # /J-;}lI- a J -(fbIQ-fX:>3Cf)-O/70 <br /> <br />SUBDIVISION <br /> <br />(OBTATN FROM PROPF.RTY TAX NOTTCF.) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br />o SIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />DALTERATION <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />D# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />~ <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~(J_ -(8l76 <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 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 />$ qt;7!5 <br />I <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o ME CHAN I CAL <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />D W.R.E.C.. <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: D BLOCK <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />***********.******************************************************* <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />MECHANICAL <br /> <br />OTHER ~ COMPANY ~~(1 '1 CJYl5frt.l (',iJrY), Ine- , <br />. J If:::.- _H_ STATE CERT R REGIST # (' ('r, - 1,~a/5l")ty) <br />SIGNATUR , _ -A- ~ Trvwn-- CITY PROCESSING # 017,1 <br /> <br />***************************************************************** <br /> <br />***************************************************************** <br />