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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 9- /j - D.3 <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME r E'A/ AI' f7'}/r-f "L.J _ r; R G vV S ~ <br /> <br />PHONE J?T.J' -, 7 gO -/1:9 ([) <br /> <br />JOB ADDRESS 3%9/ 9 <br /> <br />II Tn AUF <br /> <br />LEGAL DESCRI PTION: LOT (S) 10 ./- I ( <br /> <br />BLOCK <br /> <br />Lf7 <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # /I-olt",-.J-I-O()/C! -Ol../700 -OJIJO <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION o ADDITION OALTERATION o REPAIR ~INSTALL <br /> "'-. <br /> OSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> OCOMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK "'Z.. L A-UVA./ <br /> <br />Ii> e ( tJ-AT( t/,u S- Y~rE~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <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 />JA <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />fi-PLUMBING <br />o MECHANICAL <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 />y------. <br /> <br />/,/ 11 " <br />~ <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 />'~.AI"C..-t.. , <br />SIGNATURE I/t/'V"\ _~ ~~ <br /> <br />COMPANY 1.,../"'/ J.-ICW1f7 I7v..././vt;;:' R <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />Cm1PANY <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 />