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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />B13-7BO-0020 FAX: 813-7BO-0021 <br /> <br />DATE RECEIVED <br /> <br />/- rft(, -of <br /> <br />PHONE CONTACT FOR PERMITTING 3,s;:<-Ges ;1;2;27 <br /> <br />OWNER' S NAM~A/ <br />JOB ADDRESS ~3#4 <br /> <br />./"'i? yS;?' <br />&;0-// <br /> <br />~~-/~..G C20-S7 <br />8/v,o/J' Z~1;/?h& <br /> <br />PHONE JS2-?S-4-s-~/ <br />/L <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # J0' c2>- ;;; J - oc/ / {/ - 0 7;<00 - Go 00 <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />Os I GN <br /> <br />o ADDITION <br />o MOVE <br /> <br />p;fALTERAT I ON <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED USE: OSG1, FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOB I LE HOME <br />o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK t/.2 -c. J~.c- ov-l/C):::/cA1? //-: ~ v/t/d <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PI,ANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <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 />& (1) SET ENERGY FORMS. <br /> <br />FORM~(~t p'. <br /> <br />IV ~\ <br /> <br />..,,'- <br /> <br />cP ~ 1S <br />~ <br /> <br /> <br /> <br />PERMITS REQUESTED <br /> <br />(] BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />(] <br /> <br />(] PLUMBING <br />'fa'MECHANICAL <br /> <br />(] GAS <br /> <br />(] ROOFING <br /> <br />$ l~oSO r:5- <br /> <br />(] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />(] OTHER <br /> <br />TYPE OF CONSTRUCTION: (] BLOCK <br /> <br />(] FRAME <br /> <br />o STEEL <br /> <br />(] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />I S PROJECT IN FLOOD ZONE AREA(] YES (] NO <br /> <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <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 />*******************************************************;7**~**j**71 J / ), <br /> <br />MECHANICAL ~ / (J r. COMPANY .4s:sc.eLiO L?;a;hz.t /Y47lj 'l..J {u. '''/ <br />SIGNATURE /I/;\. ':f' ~Ad STATE CERT OR REGIST # ~o67c::<S~ <br /> <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />