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<br />, ~ <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhilla, FL 33542 <br />813-780-0020 FAX: 813-780-0021 } h - {) y - 03 <br />DATE RECEIVED +.-.iL.___ <br /> <br />PHONE CONTACT FOR PERMIT'rING <br /> <br />OWNF.R' S NAME <br /> <br />Q\) \ ~ <br />~~4\t <br /> <br />M~~ ()... \\, ~V"\. <br /> <br />'3 'I '(" IV\ n~ ~ h c. \r-::' <br />BLOCK <br /> <br />PHONE <br /> <br />JOB ADORE SS <br /> <br />I,EGA.L DESCRIPTION: LOT (3) <br /> <br />SUBDIVIS ION <br /> <br />PARCEL If) # <br /> <br />(OB.IAIN FROM... PROPERTY TM NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br />[J S IC;N <br />PROPOSED USE: OSGL FAMILY DWELLING <br />OCOM!'1ERCIAL <br /> <br />o ADDITION <br /> <br />OAI,TERA'I'ION <br /> <br />o REPA.IR <br /> <br />o INSTALL <br /> <br />o HOVE <br /> <br />[J DENOLI SH <br /> <br />OMULTI-FAMUY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o SWIMMING POOL <br /> <br />DESCRIPTION OF WORK <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />.:r~~~\\~~( ,,,,-.ig~eoO() ~ \ (\.~~ <br /> <br />S~lo ~_ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT __ <br /> <br />RESIDENTIAIJ: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF' SIGN PF:RMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />FORHS. <br /> <br />Cl BUILDING <br /> <br />o ELECTRICAL <br /> <br />o PIJUMBING <br />o MECHANICAL <br /> <br />$ <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 />F'INISHED FLOOR ELEVATIONS <br /> <br />IS PROaECT IN FLOOD ZONE AHEAD YES <br /> <br />o NO <br /> <br />L________. <br /> <br />._.~_._..__._--_._._--~~_.._--~----_.__.._-_._---_._..-------_._~-------- <br /> <br />C"O~'rQ.C~R..'.$IC'rIQN <br />. ." , . . '-,.... .. . .-.'. <br /> <br />. ~U~'uU_'U_"" -,---___..,__u_J <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />********************************************************"********* <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STA~E CERT OR REGIST # <br /> <br />********************************************************!c********* <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />**************************************k*************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER ~;u-~!t:j <br /> <br />SIGNATURE ' <br /> <br />********************************************************k******** <br /> <br /> <br />COMPANY \OJA ~ \'\t"......> ~ ~ f' . <br /> <br />STATE CERT OR REGIST # <br />