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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8m 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 />,';' ~O~e- G. <br />J73' 757~ Vv) <br />/// <br /> <br />Re-e--k <br />C,4 A/ CI r <br /> <br />PHONE 7go~ 760"3 <br />~ M /'/f <br />SUBDIVISION (/1 tLA'/c:e C;; vo v~ <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br />PROPOSED USE:~SGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[J ADDITION <br /> <br />[JALTERATION <br />[J DEMOLISH <br /> <br />Jf REPAIR <br /> <br />[J INSTALL <br /> <br />[J MOVE <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />#~TA'< <br />v::;2 /f'/ S /-/ <br /> <br />D RESTAURANT <br />fla-IV C"'.1" ~ <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />cYVrr .-.5h;',yc;7/e S <br />i/ <br />SQUARE FOOTAGE /,C.? ..;<. ?7 HEIGHT <br /> <br />BUILDING SIZE <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 />[J BUILDING <br /> <br />$ <br /> <br />pc?c/ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />$ <br /> <br />[J GAS <br /> <br />JS;;f ROOFING <br /> <br />[J SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />~ STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br />CO~O'l'Oa),iSEC'.DIO~ <br />.,....... , . . ".,' - ..',-:.':.'.,,'..; ....,,-'._ ",'_;:;- ,:"-', ..,i' <:","~." ,:, "-,,:' .;. _c"/ ,,' :-,' ,', .;: 'co: ..-', ..:-; '. <br /> <br />BUILDER <br />SIGNATURE/~~A 1?4A <br /> <br />CGMP1\NY <br /> <br />.-5:-' ~ ~ <br />~ <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 />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />