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<br />, <br /> <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 />r- <br /> <br />DATE RECE IVED <br /> <br />/ -;2 7-fji' <br /> <br />PHONE CONTACT FOR <br /> <br />PERMITTING ,~pl( <br /> <br />.~~ ~ <br />PHON0;t7 - ~jf5'- 7c1d <br /> <br />OWNER'S NAME <br /> <br />(;-ed-enu< ~ <br />5J, 1(, (}.. 3rJ <br /> <br />;lc,t-FielcP <br />S1: <br /> <br />I/Jr;q, T ~ a S"e <br /> <br />JOB ADDRESS <br /> <br />/ <br /> <br />BLOCK 0 <br /> <br />SlJBDIVI S ION 5111'1je+ Ec,:tcd-f'f <br /> <br />LEGAL DESCRIPTION: LOT (S) <br /> <br />PARCEL ID # ()") J:, .- ~/ - OJlfJ - OOOOO-/()6D <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION <br /> <br />(JSIGN <br />PROPOSED USE: ~,L FAMILY DWELLING <br />(J COMMERC IAL <br /> <br />(JADDITION <br />(J MOVE <br /> <br />(JALTERATION <br /> <br />o REPAIR <br /> <br />BINS TALL <br /> <br />o DEMOLISH <br /> <br />(JMULTI-FAMILY <br />(J INDUSTRIAL <br /> <br />0# OF UNITS <br />(J SWIMMING POOL <br /> <br />(J MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />Pkcn-el'lf eJr: Po4J'lj{ ~fJ 1'1 / CPl T() <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS. <br />COMMBRCIA1: ATTACH (3) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />(J BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />(] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />(J PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VAI,UATION OF MECHANCIAL INSTALI,ATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />(J FRAME <br /> <br />o STEEL <br /> <br />(J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br />[ I C:ONTMQ~!tF~..~ttt~QN l <br /> <br />-~~,-~-~---~--, -,~-,--~- -------- ---------'~-----------~------------'----,~------------,-----------'----------------,-~--------,- <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTnICI~--~-::) COMPANY At A Elecfy.;c (jJ. <br />S lGNATURE ~7\;;' ,4eL k STATE 9"1 OR REGl S T # :;)9 ~ ' ~ <br /> <br /> <br />* * ***** **** * ********** **** *** ** k******~Z~ *~* *,'A~('iqf* '"i/-O!~ " <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />******************************k*********************************** <br /> <br />COMPANY <br /> <br />S I GNNDTJRE <br /> <br />STATE CERT OR REGIST # <br /> <br />**********************************k****************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />