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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 />(;Jd- ,~p fit p <br />/;{ /:J~/O'2 <br />DATE RECE IVED I I <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />L-kc.IJ~'....:l ~{l ""2....t..w.ylJ.l.. L.:......t:.J <br />~ A. 4i A~e'''' .,.. ~J '=" <br /> <br />PHONE~ /1~1-~ '1{J9-oo1/ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # 10. '1.b. '1..\ . 00\0 - \"LI.Oo - cr>~ <br /> <br />(OBTAIN FROM PROPERTY TAX ijOTICEl <br /> <br />WORK PROPSED: ONEW CONSTRUCTION o ADDITION OALTERATION o REPAIR s;(i"NSTALL <br /> Os I GN o MOVE 0 DEMOLISH <br />PROPOSED USE: OSG1 FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL OSWIMMING POOL o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />TII\4~..l\ ~ \J ~2L.~t-4doll QC'IC ,'t" o\"~ Mo\.tioL ~D__ (...o\;- <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMHERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <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 />& (1) SET ENERGY FORMS. <br />FORMS. ../'_.---------..... <br /> <br />.///---~ <br /> <br />;~~ <br /> <br /> <br />AMP SERVICE <br /> <br />~FLORIDA POWER <br /> <br />o <br /> <br />W.R. . . <br /> <br /> <br />o BUILDING <br />~ ELECTRICAL <br /> <br />$ <br /> <br />300 . 00 <br />100 A. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />.0 OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br />r----.-- <br /> <br />~~J(;,';',~~~~[;~ <br /> <br />l <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br />SIGNATURE ~h ~ {\ ..<-~ <br /> <br />COMPANY~e't.yo ulll ~~v :c.....l f 'l:::uL. <br />STATE CERT OR REGIST # 14~1~ <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 RECaST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />