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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8th Street, Zephyrhills, FL 33542 ,I <br />813-780-0020 FAX:813-780-0021 -1/GfIOyV <br />DATE RECEIVED A, +j , <br />PLANS REVIEW FEE <br /> <br />. <br /> <br />OWNER'S NAME ~()J-) KU.~b~ PHONE 115.qO~5 <br />JOB ADDRESS'3Cl500 ~..t)o.orl ~ . <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISIONr=~ ~ <br />PARCEL 10 # 12:>.:;;}Co- ~l~DI40.000(:(:).-I6CC:> (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION o ADDITION OALTERATION o HEPAIR 'iUJNSTALL <br /> OSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: {GSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERC IAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK QiA ConC(0h.1-~ ~~ Q rl <br />BUILDING SIZE SQUARE FOOTAGE HEIGHT <br /> <br />RES I DENTIAL: <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 />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELEC,!'RICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W,R.E.C. <br /> <br />o PLUMBING <br />~lECHANICAL <br /> <br />$ <br /> <br />45CO.OO <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 <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />1 <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br />SIGNA~URE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br /> <br />*****************************************^~****~****~***~l: . <br /> <br />COMPANy=:!s:~D 'S AI ("" II Df\) , t\.):3 <br />- -"-""'";/0 0'/ STATE CERT OR REGIST # RrnOOl C{q 3, <br />~..... V~//i;/ CITY PROCESSING # II <br /> <br />MECHANICAL <br /> <br />************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />***-k************************************************************* <br />