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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME";;:~ ~ ,~/'71"~ <br />JOB ADDRESS ~"7~ -V~ ~-r-' ~~~ <br /> <br />PHONE Y/./I 7-;'3 4~~ <br /> <br />IJEGAL DESCRIP1'ION: I,OT (S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERC IAL <br /> <br />o MOVE <br /> <br />o DEMOI,ISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SW IMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />s~~ <br /> <br />I~X/~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />o BUILDING <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. '.f .;.......... .",... ""'...H <br />.ALV,~INU)V\ V.....'..:H, ,PO''''''"\/ <br /> <br />PERMITS REQUESTED ~~~il(.hO f{,[) <br />? .J,\~\I fCNliOt'- /~LO() <br />VALUATION OF TOTAL CONSTRUCTt6N f'\K <br />C~VI~ &-~ L'1liJ~ <br />o FLORIDA POWER 0 W.R.E.C. <br />uJI1B- <br /> <br />$ J 114 , ~ ., <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL <br /> <br />t 16 t'-tf it <br />WiND L6A-'P <br />INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCT ION: 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 0 NO <br /> <br />co~~~~~rl*'~~'~9~ ----------------~__,__,_J <br />COMPANY VuJrJVY" <br /> <br />BUILDER <br />SIGNATURE.. ;fi~..J 4..J <br /> <br />~.~ <br /> <br />STATE CERT OR REGIST # <br /> <br />********************************************************,,********* <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIS! # <br /> <br />********************************************************.,********* <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br />SIGNATURE~~.J. ~ ;f;:;t~ <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br />