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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 eTH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />J- 2 b-I/I <br /> <br />, <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ~;~ <br />JOB ADDRESS ,)20 I <br /> <br />- ~--- <br />5 ~( !Cd. fJ- ( /. <br />;( ~ .si <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(5) <br /> <br />BLOCK <br /> <br />PARCETJ ID # i 2 -)1 - 21- OOIC - O),c'oo - eno <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION <br /> <br />(JADDITION <br /> <br />~LTERATION <br /> <br />(J REPAIR <br /> <br />(J INSTALL <br /> <br />(J SIGN <br />PROPOSED USE: ~L FAMILY DWELLING <br />(J COMMERCIAL <br /> <br />(J MOVE <br /> <br />(J DEMOLISH <br /> <br />(JMULTI-FAMILY <br />(] INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />(] MOB I LE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />12 ~ -12 (X!-/IJ {'- 6 0 % <br />/ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <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 />AMP SERVICE <br /> <br />(] FLORIDA POWER <br /> <br /> <br />/ <br />/ <br /> <br />';i BUILDING <br />o Er,ECTRICATJ <br /> <br />$fI?c,){) [7 <br /> <br />/ r <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o <br /> <br />o PLUMBING <br />o MECHANICAL $ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />(] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION'~ tJ1. <br />(] f, 41,5, I).? A Id t) <br />OTHER l" ~. / '-'r r1" <br /> <br />o FRAME 0 STEEL 0 OTHER .11J~' <br /> <br />IS PROJECT IN HOOD ZO~EAO YES 0 NO <br /> <br />TYPE OF CONSTRUCTION: (] BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br /> <br />SIGNATURE <br /> <br />~t!-' <br /> <br />j}6~ <br /> <br />COMPANY <br /> <br />;' . <br />{-,q.(/ / V <br /> <br />I!reevCi/ {:. <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # l(tCCf(6itf/ <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 <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REG 1ST # <br />