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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPAR~~NT 5335 8~H 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 N>Mf]ft a;. ~. <br /> <br />JOB ADDRESS '379)Cj Cr 4~ krot- <br />LEGAL DESCRIPTION: LorI' (S) I/? <br />PJ.IJ<.CEL ID # -2t...,;;lto-c;.I-f>O ~D -ca:soO'- <br />WORK PROPSED: ~CONSTRUCTION o ADDITION <br /> <br />PHONE &:15- '179J>' <br />"2-- #~~ <br /> <br />SUBDIVISION 1r{1J~h<- (jiHCS .elu. <br />0750 (OBTAIN mOM PROPERTY TAX NOTICE l <br /> <br />BLOCK <br /> <br />OALTERA'l'ION <br /> <br />o REPAIR <br /> <br />D INSTALL <br /> <br />D SIGN <br /> <br />D MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />D COMt1ERCIAL <br /> <br />DMULT I - FAMILY <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOB HE HON! <br />o OTHER <br /> <br />o INDUSTRIAL <br /> <br />DESCRIPTION Ot' WORK <br /> <br />CJ RES'fAURANT & HEALTH DEPARTME:NT APPROVAl, <br /> <br />/~,K 50 <br /> <br />" <br /> <br />D'1 / ~<- <br />6::)0 <br /> <br />HEIGHT <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />o BUILDING <br /> <br />PERMITS REQUESTED <br />/ ~CJO .c:;0 <br /> <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY <br />C011J."lERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IE' SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />$ <br /> <br />VALUATION OF TO'rAL 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 MECHANICAL <br /> <br />$------ VALUATION OF NECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />rJ SPECIAL'fY <br /> <br />o O'l'HEf. <br /> <br />TYPE OF CONSTRUCTION: D BLOCK. <br /> <br />o FRANE <br /> <br />D S'rEEL <br /> <br />[] OTHER <br /> <br />FINISHED HOOR ELEVlI_'l'IONS <br /> <br />IS PROJECT IN FLOOD ZONE: AREAD YES <br /> <br />o NO <br /> <br />r--.------.---.--------------~-----. .... .;~.~.---;:-;:;. <br />CONTAACTOI{"j~~~tcION <br /> <br />._~-~---_.~-_..~.~-_._...._~~.,---~----_....-----~-~ <br /> <br />BUILDER <br /> <br />CONPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />*********~*********************~********~**************~********** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGHATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************~************************************************** <br /> <br />PLUMBER <br /> <br />COr1PANY <br /> <br />~-""----'-~-'-----_._." <br /> <br />S IGNA'rURE <br /> <br />STATE CER'I' OR REGIST # <br /> <br />l'4ECHANIC'.AL <br /> <br />********~*****~**************~*~**~******************************* <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # _. <br /> <br />***************************************************************** <br /> <br /> <br />OTHER ~~h C&?1 r.4...-9C""',,=- COMPANY ~C/h:, C(171c..e~k <br /> <br />SIGNATU " ~~~ 1 ~- STATE CER'T OR REGIS'l' n..~~=~/;<_,":__._~._ <br />a- />?5LO JI= 0'1777 <br />