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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 />11J--~9-u9 <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />PARCEL ID # tJh?Jp ~\ 0\ So rt{J1) O~ ?JO <br /> <br /> <br />P HONE t\~ ' 1''0 ~.J tJ\q ~ <br />~W~:;l <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: o NEW CONSTRUCTION o ADDITION ~ALTERATION o REPAIR o INSTALL <br /> OSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: ~SGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />ee( <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />-~""""-"'-'-'.'.'-'" <br /> <br />'l!J BUILDING <br />0 ELECTRICAL <br />0 PLUMBING <br />0 MECHANICAL <br /> <br />$ <br /> <br />woo. cD <br /> <br />--") <br />PLANS & (2) SETS OF BUILDING PLANS &.. (l)/st:-;rU' NERG\ FORMS. <br />OF BUILDING PLANS & (1) SET ENERGY F.?!3-M~;. '55~) <br />REQUIRED FOR ALL NEN CONSTRUCTION. (I.,i.L- f9 1,' ~ <br /> <br /> <br />PERMITS REQUESTED // 0 ' ,. . g~~ r ;/ <br />/ iflf,l/ QI,?lq~,~ <br />VALUATION OF TOTAL CON$TRUCTI . a 11M' I ~ Iq / <br />\ aC~r / <br />o FLORIDA PO~R ~._ 0 ' w~../) <br />-----.- f ~ ~//--- <br />VALUATION OF MECHANCIAL INSTALLATION , .'",,/,\ <br /> <br />./,;::.> '1& 0 <br />/..~~ <br /> <br />'\ <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT <br />ATTACH (3) SETS <br />PROPERTY SURVEY <br /> <br />AMP SERVICE <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br /> <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OT HER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE <br /> <br />o NO <br /> <br />SIGNATURE <br /> <br />.~.a:L~J~": ~ <br /> <br /> <br />COMPANY <br />STATE CERT OR REGIST <br />CITY PROCESSING # <br /> <br />BUILDER <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 />Cm1PANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />