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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 />t~efl />~::<
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<br />DATE RECEIVED
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<br />PHONE CONTACT FOR PERMITTING
<br />
<br />OWNER'S NAME
<br />
<br />/(,fJ. "'117
<br />S:) u'1 &i frcv--
<br />
<br />J(~ fkt~ 1
<br />/
<br />'Z'f'A7/ h 1/0
<br />BLOCK 3
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<br />PHONE Cy/'I) '610 ;-Y0 <;'"
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<br />JOB ADDRESS
<br />
<br />Dr
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<br />LEGAL DESCRIPTION: LOT(S) I~
<br />PARCEL ID # 1;)..1" ,) I 00JO 00300
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<br />SUBDIVISION
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<br />'Ddo
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<br />(ORTAIN FROM PROPERTY TAX NOTICEl
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<br />WORK PROPSED: []NEW CONSTRUCTION pst ADDITION )QALTERATION [] REPAIR [] INSTALL
<br /> [] SIGN [] MOVE [] DEMOLISH
<br />PROPOSED USE:~SGL FAMILY DWELLING []MULTI-FAMILY []# OF UNITS [] MOBILE HOME
<br /> [] COMMERCIAL [] INDUSTRIAL [] SWIMMING POOL [] OTHER
<br />
<br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL
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<br />DESCRIPTION OF WORK ~), ;4~.(cI 3 s;b w~//5 f... ~,'sf':.I1,f ~\""j vJ~'....c.... SiMS G.(f~ ~,'S r5
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<br />BUILDING SIZE I~,I ;CIJ../ SQUARE FOOTAGE //0 ,'"ISIt:'&' flfo. HEIGHT ~;
<br />
<br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDIN~'TE!!~RMS'
<br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ~ __
<br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIR :A<Jt:'-
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTI N.~~~CTT ~
<br />~ f5.-!{"\JN1~ f
<br />~ lJ ,'Ln.;)
<br />PERMITS REQUESTED'
<br />
<br />~UILDING
<br />[] ELECTRICAL
<br />
<br />$ SaO
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />[] FLORID~t== ~JR~~
<br />f\i)DI Tl"'" I'l-= fi,fW\/t -r,.. ,"
<br />~Ulr'\.\;'O ~~-r :r'lP~
<br />o f Tn.t..l r'\ L 1;1- T<. ,
<br />VALUATION OF MECHANCrlu. l~'ti:LATION / /'j{~
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<br />[] OTHER
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<br />[] PLUMBING
<br />[] MECHANICAL
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<br />$
<br />
<br />[] GAS
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<br />[] ROOFING
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<br />[] SPECIALTY
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<br />TYPE OF CONSTRUCTION: n,( BLOCK
<br />FINISHED FLOOR ELEVATIONS
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<br />[] FRAME
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<br />[] STEEL
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<br />[] OTHER
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<br />IS PROJECT IN FLOOD ZONE AREA[] YES \S(NO
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<br />BUILDER
<br />SIGNATURE ~\~
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<br />CO~O!l'QR~'X$SOml:<;)~
<br />'., ,CO," ;...;,,:'. ,', ,'.:" :,"," ,.,:......-,> ,,',- '-'-::":'_,, '_i';>.,.:.,;,:.:'"".',.~!,_::. .- ",.,_, ',,:. '.; ...: .'_~'.. "~,,';;:_,;. c'",
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<br />COMPANY -- ~
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<br />o WI1.e'Y'
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<br />STATE CERT OR REGIST # /VI A--
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<br />********************************************************~*********
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<br />ELECTRICIAN
<br />
<br />COMPANY
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<br />SIGNATURE
<br />
<br />STATE CERT OR REGIST #
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<br />******************************************************************
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<br />PLUMBER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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<br />MECHANICAL
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<br />******************************************************************
<br />
<br />COMPANY
<br />
<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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<br />*****************************************************************
<br />
<br />OTHER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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