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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 Olr!
<br />DATE RECE IVE~-f-t?....3---
<br />PLANS REVIEW FEE
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<br />"Y,'i~;ER':: rlp.r'lE
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<br />&1/klLf L.
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<br />JlI/
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<br />PHONE 70"(- r z 9~/C!..~,
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<br />JOB ,i\DDRESS
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<br />~~3(
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<br />7?J (/ I'!.~ I9-llu -e. ,0 /L
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<br />I, ;i"ES:'F~F'iL)ij: UH(S)
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<br />B j(X' K
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<br />S lJ B [J I V I S I Ol'i
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<br />PARCEL ID #
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<br />2c..f ~ U -2/ - OOIl:>O ,- ?JC/O~O-2~U;) (OBTAIN FROM PROPERTY TAX NOTlJ'::EL_
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<br />HI '<f< ?PClp~;Er,: ~'lEVi -'\JNSTRUCTlill,J
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<br />o AUf)!TFiI:
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<br />o i\ lTF.RAT ION
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<br />o R F: P A I R
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<br />[J IllSI'll.!,!
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<br />[J ,;!')
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<br />o [Ji(l\! E.
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<br />n IJE:MOLISfi
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<br />,,'F' 'f'U,SE.
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<br />(;t: [JS!;! ~i\I'1ILY DWELL1I'i<;
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<br />b!"1IJLTL-FJlJvj] I,Y
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<br />o C\i["1I''1E RC I AI,
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<br />o HmlJ~;TR r Al
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<br />0# OF ImI'1'5
<br />o SWH1MHlG POOL
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<br />o l'lCi[3T LE
<br />o OTHER
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<br />(il:'
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<br />D RESTAURAIJT & HEALTH DEPARTMENT APPROVAL
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<br />DESCRIPTION OF WORK
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<br />/6 X L Z
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<br />L-;fl;L/PI-~
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<br />BriT IDING SIZE
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<br />/OK Z 2..
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<br />SQUARE fOOTAGE',
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<br />'2-20
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<br />HEIGHT
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<br />"USTDPITIAL:
<br />"(:lvlHFRCIi\L:
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<br />ATT1\.CH (2) Pl:n PLANS & (2) SETS OF BfJILDING PLANS & (1) SFT FNFRC;Y ['IIR!d,;
<br />ATTACH (3) SET~ OF BUILDING PLANS & (I) SET ENERGY FORMS,
<br />PROPERTY SlJRVEY REQUI RED FOK ALL NE\tJ '=OtlSTEIJCTION.
<br />
<br />M1P SERVICE
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<br />o t~; ()P,'; DA POWER
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<br />l){ pi ; ! 1 r Ih~
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<br />?1 ~ ~ 2L
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<br />PERMITS REQUESTED
<br />
<br />VAUIATImJ OF TilTAL CONSTRUCTlC)l~
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<br />1"1
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<br />~'l"-: j\PJ(~'r;l
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<br />o W. R, E,C',
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<br />o ::l' !I~Bn]c.;
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<br />[] ii Hi\1 i~'r,j
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<br />VALUA TI OI.J m~ ~~r.:C HAIre r A L I ['JST ALLATT OIJ
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<br />[1 ,;I.,S
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<br />o ROO E' I !ll:;
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<br />o SPECTJl.LTY
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<br />o (Yi'IlER
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<br />11 E F C\l!]STRljC'T rot!: 0 BLOCK
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<br />o E'RAHE
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<br />o STU:I
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<br />o OTHER
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<br />E i 111 SHED Fil)(JK EI,EV,i\TIClNS
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<br />IS PRO,1E:CT IN fLOOD ZONE: Jl.READ YES
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<br />,STJlH (ERT OR RE:C; t S1' iI Cl!3L/zr~t?z~.__,
<br />,'lTY PROCESSING #
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<br />BUILDER
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<br />ELECTRICIAN
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<br />CCll'1 P !\IJ Y
<br />ST1\1'E CERT OR REGIST #
<br />!'ITY PROCESSING #
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<br />~' ,IJATIIRE
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<br />PUJMBER
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<br />C'O~.1 P A!'J Y
<br />STATE CERT OR REGIST #
<br />ITY PROCESSING #
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<br />s: 1;!Jl\TURE
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<br />MECHANICAl, ('I ilJjPAWl'
<br />:;n\TE ('ERT Cif{ REC;JST #
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<br />OTHER CGHPANY
<br />STATE CERT OR REGIST #
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