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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 02- 4- all <br />DATE RECEIVED . ... <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />C (i' / Or: tL PINt<.. 14 t U.... s <br /> <br />~92:2u _ -:; d;)? <br /> <br />PHONE <br /> <br />JOB A!DDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCElL ID # <br />WORK PROPSED: []NEW CONSTRUCTION <br />[] SIGN <br />PROPOSED USE: []SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />[] ADDITION <br />[] MOVE <br /> <br />[]ALTERATION <br />[] DEMOLISH <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBILE HOME <br />[] OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF W~_._--() ./A(1/ 0 ~ F7) <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (J.) 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 />PERMITS REQUESTED <br /> <br />[] BUILDING <br />[] ELECTRICAL <br /> <br />$ 4S-3s-~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />[] PLUMlBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES [] NO <br /> <br />!Z<>~C~~,$E~TIQ~ <br />. . ...',.... '. <br /> <br />SIGNATURE <br /> <br />1{1 e ~:f? <br /> <br />COMPANY C(Zr.:'~5 f'otV;,T/-'U::..."T1 Cl N {'-<'?.I /./VC_. <br /> <br />BUILDJ!:R <br /> <br />STATE CERT OR REGIST # ('..-0 c 15"0-S-17<:'-;- <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBtR <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNA['URE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHERI <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />