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<br />CITY OFZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TR St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br />S ------ <br />- \JeW <br />OWNF,R'S NAMF;~ WC\\Mll--\+ PHONE .:=J3b- 06\-1'-{~1'-( <br /> <br />JOB ADDRESS~____-----.:.. ~ 7f3( G~/;II/t/, <br /> <br />LEGAL DESCRIPTION: 10'1'(5) <br /> <br />B10CK <br /> <br />SUBDIVISION <br /> <br />PARCEL If) # <br /> <br />( QB.l'lUN FROM PRO PER T :c.1'AX NOT! CE ) <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br />Os I GN <br /> <br />o ADDITION <br /> <br />o ALTERATI ON <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />[.1 DEMOLISH <br /> <br />PROPOSED USE: OSG1 FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING PCOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />/: -r: J e'...-r f'VI'II;{V(-t..CJ RESTAURANT & HEALTH DEPARTMENT ]\PPROVAL <br />rllCf t?t r al" C{ /----- '-fj.. 'f1-. <br />DESCRIPTION OF WORK ~- (eAtf JvW( ~ --::TcuY\. '"~___~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE _________ <br /> <br />HEIGHT <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. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R,E,C. <br /> <br />o PLUMBING <br />o MECHANICAlJ <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />r.J ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF C:ONS'l'RUCTION: 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 />1-__,_,.__.__ .u. <br /> <br />._._---.._-~--------_...,-- ---_.__.,-----_.._'~.,._._--_._---~----~-------_._---,---.------.-.-.--- --..-" -.-..--.---.. -.---..---. -..------ - <br /> <br />CONTM~fO:R'~rs~l:'J!xc:>N <br /> <br />." --, -----,--_____., ,I <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 />STATE CER'l' OR REGIST # <br /> <br />***~*****************************h********************~*********** <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 />OT"E~/L~ ~ <br /> <br />SIGNATURE <br /> <br />*****************,**********************************************~* <br /> <br />COMPANY Ar;Fnf dr~d <br /> <br />STATE CERT OR REGIST # <br />