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<br />......."'\~.:.. <br /> <br />RECEIVE <br /> <br />y ." <br />, ~lt <br />iWJi-700-0020 <br /> <br />OCT 2 5 20rJte Recer-ed <br /> <br />t f7 15 '6 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />;Je O--f\ei-k ~k I ( <br /> <br />I <br />I <br />J <br />I <br />I 7643 Gall Blvd., Zephyrhills, FL 33541 I LOT # L_4__J <br />PARCEL 10# I 34-25-21-0110-00000-0040 I * <br /> <br />IOBTAINEO FROM PROPERTY TAX Nor.cE) <br /> <br /> <br />() - 2~ -<> '1 <br /> <br />~-"11""""O-''''!o.o..c'' ,Ownet:s ~l!\e Brinker Florida, Inc. <br />~,p\" \.,,,I,il.U " , . <br />-' "'j,1~ .biv1~!Oownor'sAddresJ I 6820 LBJ Freeway, Dallas. Tx 75240 <br /> <br />"--^' , F.e~;~~;~'~::~old"'Nam.1 Brinker Florida. Inc. <br /> <br />Foo Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />* i~J1 <br />\. \}01 <br />~C\~ <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />lYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />r--- , ,--- <br />i 6820 LBJ Freeway, Dallas, Tx 75240 <br /> <br />~~~~~~I=-~~!.'.ercenter.A Replat ! <br /> <br />D NEW CONSTR u:;;t ~L T 0 <br />D INSTALL D ~AIR <br />o SFR [id-- COMM 0 OTHER <br />o BLOCK U2r FRAME 0 STeEL D <br /> <br />Dining expansion to existing Chili's restauran.t <br /> <br />I SQFooTAGE 4,647 s.f. j HEIGHT I 22'-10" <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE 0 <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />It <br /> <br />0 BUILDING <br />0 ELECTRICAL <br />0 PLUMBING <br />0 MECHANICAL <br />0 CAS <br /> <br />1$ 110,000 <br /> <br />1$ 14,500 <br /> <br />1$ 0 <br /> <br />IS 12,500 <br />o ROOFING <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />'-- <br /> <br />Address <br /> <br />PlUMaEi<-. .J <br />SIGNATUR~' I <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />I <br />I <br />I <br />I <br />D <br /> <br />OTHER <br />DYES <br /> <br />D <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />WRE.C. <br /> <br />AMP SERVICE <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALlY D <br />FLOOD ZONE AREA <br /> <br />DNO <br /> <br />I <br /> <br />S I) oj t'ij ~ -E L -<-G7/L .( ..r4,c;-s- <br />CYZJ.[J FEE CURRENT ~ <br />Llc&nse # I Ell. lJ b J '1 "J oJ' <br /> <br />License /I <br /> <br />I <br />I- <br />I <br />I f)if. ~t~ <br /> <br />S:''/s'" <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) sel c:J Energy Forms <br />Minimum ten (10) working days after submittal date. Required onslte. Ccnstruction Plans. Sanilary Facilities & 1 dumpster <br />Allam (3) sets of Building Plans; (1) set of Energy Forms. <br />Minimum ten (10) working days after submittal dale. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster <br />All commercial requirements must meel compliance. <br />Attach (2) sets of Engineered Plans <br />....PROPERTY SURVEY required lor all NEW construenon <br />1 <br /> <br />Directions: <br />Fill out application completely. <br />ONrlOr & Contractor sign back of application, notarized <br />If ov.r $2500. a Notic. of Commencement Is required. (AlC upgrades ovor $5000) <br /> <br />Agenl (to( the contractor) or Power eX Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMlmNG (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC <br /> <br />Drhleways-Not over Counter if on public roadways..needs ROW <br /> <br />Fances (P1oVSurvey/Footaga) <br />