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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 e~ Stre.e,;Zephyrhill., FL 33542 ~ It <br />813-78P-0020 FAX:b13-780-0021 <br />DATE RECE IWD ;J 5, 05" <br />PLANS REVIEW FEE <br /> <br />OWNER'S NAME &/2/A-NO J-/DiZ( Za;U M;-/P <br /> <br />JOB ADDRESS "37'/61 Cr fA.... /) vE L 'D T 1'7,f- <br /> <br />PHONE e'/3 - '7tf z -/66'( <br /> <br />SUBDIVISION, Gtl/JA.;v llolt( lD,.u /1?1-/;? <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL 10 # J If - 2'5 .... 2--1- [)of D - DZcroo- 0/7 rr <br />WORK PROPSED: ~W CONSTRUCTION ~DITION <br /> <br />/OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />IiJ-rNSTALL <br /> <br />OSIGN <br />PROPOSED USE: ~L FAMILY DWELLING <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />~1~9'1& <br /> <br /> <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />n---:4lv'M I,l/V /t/L <br />~OTHER <br /> <br />/' <br /> <br />,)1lV'''1. <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />hsz <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS &, (2) SETS OF BUILDING PLANS <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. '\.... ~ ' <br />I ~ (1, -.; ~lO( <br />~ r, '-0 <br /> <br /> <br />8'i3lIILDING <br />c;yELECTRI CAL <br /> <br />$ <br /> <br />17010, y~ <br /> <br />VALUATION OF TOTAL CONSTRUCT I <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br /> <br />I.~ q 10 .. /./ <br />4~. <br /> <br />,,/ <br />-........ <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 AREAD YES 0 NO <br /> <br />,I <br /> <br />SIGNATURE <br /> <br />~ <br /> <br />/l f2JM-f <br /> <br />:,_,..d....dd....d,.... <br />....... ...,., <br /> <br />C~MPANY !5fl+ {fYI,;"if1Lt/f:T I ON f);:- C,cIUT/?.PL ;:::/... , <br />STATE CERT OR REGIST # ('& /J 5" '77cr- z... <br />CITY PROCESSING * ~<P <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />I~~ <br /> <br />/:r <br /> <br />rhlrf' f) <br /> <br />COMPANY A-u.~ l~-f./;( C III ( c <br />STATE CERT OR REGIST * <br />CITY PROCESSING * 1cP-7 <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br />'. <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST * <br />CITY PROCESSING * <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 />