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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 <br /> <br />jrt- eue Il S <br />5<iO\ I~ +1. <br /> <br />fCad <br />1/ .ILI --1\ .I.." , F,dW'- <br />+- ~QTfI (Ph I -rQ TTlctoJllct>I':f'ctnd:.-r PHONE <br />:::rt-r ~ * <br /> <br />~/3 ;?1f5- 35'35/ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # ! '-.;{lo-a 1-0010.' 03>'800 --003:.0 <br /> <br />(OBTAIN fROM PROPERTY TAX ~OTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br />D SIGN <br /> <br />DADDITION <br /> <br />DAL'rERATION <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />D MOVE <br /> <br />[i DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />D# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOB r LE HOME <br />D OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />'\}ern 0 \ '(s ~ <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 />D 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 />D PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLA'I'ION <br /> <br />D GAS <br /> <br />D ROOFING <br /> <br />D SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />o E'RAMt:: <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />E'INISHEIJ FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />D NO <br /> <br /> <br />. ::w"iM!I <br />:",:~W& <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />(~~-CA~~ <br /> <br />~ <br /> <br />COMPANY <br /> <br />C?~1 <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <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 />STA,TE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE, <br /> <br />STATE CERT OR REG 1ST # <br />