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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 RECEIVED <br /> <br />j:2?-Of' <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />tUif '1#L.. 1!1~ H ",,'Ij <br />)4 ,'..-- - <br />.5'3/ ( /J ::Jlr-. '- <... ( <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />BLOCK S?-- <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br />[]SIGN <br /> <br />[]ADDITION <br /> <br />[]ALTERATION <br />EJ- DEMOLISH <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />DMOVE <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />[]MULT I - FAMILY <br />D INDUSTRIAL <br /> <br />[]# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOB I LE HOME <br />[] OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAl, <br /> <br />DESCRXPTION OF WORK <br /> <br />4-?06~ t, <br /> <br />(j I.f.-~ /J vj ~ <br /> <br />BUILD!rNG SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PIJOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY <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 />~ILlinNG <br />//- <br />[] EI>ECtRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />"..--~ <br /> <br /> <br />,~;:J It (p q <br />( /' .' <br />~/ <br /> <br />" "...,-.._'''" <br />FORMS. \ <br />\ <br />1 <br /> <br />PERMITS REQUESTED <br /> <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />FLORIDA POWER <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />D PLUM$ING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE CJlF CONSTRUCTION: [] BLOCK <br /> <br />D FRAME <br /> <br />[] STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br /> <br /> <br />/ <br />COMP~' flv.""?<::.. 0~.....f{. <br /> <br /> <br />BUILDJ!lR <br />SIGNATURE/~ VJ~4~/j!J <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 />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER I <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />