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<br />DATE RECEIVED <br /> <br /> <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 />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />ffefilf ~1!L <br />l3~~(. ~~ <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />P ARCE LID # ~~:.... ;2:S--- ,).-{ '- 0 \.0 ,::;-.-rl- - ~ C) (') 00 <br /> <br />SUBDIVISION <br />(<{s---a <br />(OBTAIN FROM PROPER1'Y TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION o ADDITION OALTERATION [J REPAIR [J INSTALL <br /> [J SIGN [J MOVE [J DEMOLISH <br />PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY [J# OF UNITS [J MOBILE HOME <br /> OCOMl1ERCIAL [J INDUSTRIAIJ o SWIMMING POOL o OTHER <br /> <br />BUILDING SIZE <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~~ <br /> <br />' S ARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <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 />[J BUILDING <br /> <br />$ <br /> <br />3'110 <br />I <br /> <br />PERMITS REQUESTED <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 />VALUATION OF MECHANCIAL INSTALlATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />[J OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />D FRAME <br /> <br />[J STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />[J NO <br /> <br /> <br />. ,~.,.. ...IJ".'S"'....."gm.. "'...0" N <br />,- ,-,. .,' .,. ' -'" . <br />',__:....., '6"1"__, ",", T' , ~;.'" <br />'_'" "_ '0 ,', 'ih>.. .;.,_ ,. .: _ ': ,', <br />, ,~,,---; ,.p. _ '4d~;t~,.-:; k.~._,~,,~_:'~,,_~I~t,:,.~.,n <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIS'f # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************;k************************************** <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 />SIGNATURE <br /> <br />II- ~~~~., <br />, 4 /;:; <br />11// " <br />I. r'~/,,f} , <br />-I <br />/............~...-. / <br />c-/ <br /> <br />*******k*~'******************************** <br /> <br />OTHER <br /> <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />-- <br />