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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 RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />;11 ;1 fL~ 7 )/u ~~~~ <br />53 J ( (3df! t:>r-\ A . <br /> <br />beL I K/1/n <br /> <br />PHONE (S,1) ~N \''/v<) <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: []NEW CONSTRUCTION <br />[]SIGN <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />~ADDITION <br />[] MOVE <br /> <br />~ALTERATION <br />[] DEMOLISH <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />PROPOSED USE: fQSGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBILE HOME <br />[] OTHER <br /> <br />DESCRIPTION OF <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAIJ <br /> <br />WORK at" J 5",A: vJctll-'" 10 ~~Yl-(,A? b/~(..J~ <;)...b ~ Z-y,5 ts <br />{;:.:"ril,," ir r <br />/)/;c /...1" SQUARE FOOTAGE )/0 i"J;.,4 51 FI HEIGHT 'X' <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PI~S & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PEffi1IT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />[] BUILDING <br /> <br />$ <br /> <br />~oo <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W.R,E,C. <br /> <br />[] PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: Ull BLOCK <br /> <br />o FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE llliEA[] YES <br /> <br />o NO <br /> <br />l <br /> <br />',:"It..~e~~C~'S:ir''l':r~'" <br />CO......:oI.i~;.,.yR ",0" """'"" <br />.-.' <.,.,'. ,..c... .'-: ",:.., -,.1" .~.,_~~..,.. , .' -." ..,.,...,.. ,... 7 .... .'. '."_'-.0 , "", ",':. <br /> <br />l <br /> <br />BUILDER <br />SIGNATURE ~ 5J/~~7 <br /> <br />COMPANY <br /> <br />Vu /IV <br /> <br />STATE CERT OR REGIST # <br /> <br />rJl-' <br /> <br />*********************************************************>******** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # _ <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPA."JY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />****************************************************************** <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 />