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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 />~-d-O~ <br />f <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ~ U;J 1.1. ( f: R Ie?> ~ S <br />JOB ADDRESS ~.s Ol 0 F?: /~~ ~ ~. <br /> <br />PHONE <br /> <br />LEGAL, DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: ~NEW CONSTRUCTION <br />OSIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />(QBTAIN FROM PROPERTY TAX IiQ.TICEl <br /> <br />o ADDITION <br />o MOVE <br /> <br />OALTEPATION <br /> <br />o REPAIR <br /> <br />~ INSTALL <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOB HE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK d. f(!~/;, t /;" c J:: ENe... ~ <br />I <br />BUILDING SIZE SQUARE FOOTA~E~Z <br />, ~ ----,,' <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF(BUILDii;;LANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & 'tlL.SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED F'OR ALL NEW CONSTRUCTION. <br /> <br />HEIGHT <:;; <br /> <br />r <br /> <br />$-BUILDING <br />o ELECTRICAL <br /> <br />$ /.s-O 0 . 0 0 <br /> <br />PERMITS REQUESTED <br /> <br />& (l) SET ENERGY FORMS, <br />FORMS, <br /> <br /> <br />//q~ <br />~, <br />// <br />- I .-/ <br />---:.---..---..-- . <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />D W,R,E.C, <br /> <br />D PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D GAS <br /> <br />D ROOFING <br /> <br />D SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />I___L___________.. <br /> <br />c:01!t~OlQg"[,;,SsQ~J.t.Q~ J <br />,< -, ,". '. ,.... '" ,.' ,"... 'Co,'. '.' .'.~,."."'.".. "r., .,. .. '''~''.' ,,' _,'_.' ,. .'. '....~'.,". ,',,_, .,_""~.,.. ^'..'. " <br /> <br />SUILDER -1. A <br />SIGNATURE . ~ ~A' ~ <br /> <br />COMPANY tJ, Lro "'/ c:;- /'ITc~~;? S' EO.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 />MECHANllCAL <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 />