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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 RECEIVED <br /> <br />.2 -110 - of <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME:t:.n lCAC\d 2>oU-%eQ~-\- m.€xchcn~ PHONE -Xl o-lg& -loto<o L <br />JOB ~DRESSI()L\~ qcd\ 6\Ld 'L.-h; ll~ F L 33540 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARC!tL ID # 1t}-dU-- ~ 1-0000 -(')030 -00 ~ <J <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />D SIGN <br /> <br />D ADDITION <br /> <br />[JALTERATION <br />D DEMOLISH <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />D MOVE <br /> <br />PRO~OSED USE: DSGL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />D# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOBILE HOME <br />DOTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCItIPTION OF WORK In&lc\\ B-e..C~lc... -to o--Ff;'Ce. <br /> <br />(nod ~ <br /> <br />BUILQING SIZE SQUARE FOOTAGE <br />I <br /> <br />HEIGHT <br /> <br />RESIqENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />CO~RCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF :SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. A~C~ <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. f' ~ 4 ~__~ ?" /' <br /> <br />// 1A1, 11l(J- __<.-'>-' <br />, '-~ II (.,FII ..,..--~ <br />PERMITS REQUESTEDC. ~.#. <br /> <br />) <br /> <br />D BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J ELEC1rRICAL <br /> <br />\~S <br /> <br />AMP SERVICE <br /> <br />~ FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />D PL~ING <br />D MECHANICAL $ <br />D GAS I [J ROOFING [J SPECIALTY <br />TYPE ~F CONSTRUCTION: [J BLOCK <br />FINISaED FLOOR ELEVATIONS <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D OTHER <br /> <br />D FRAME <br /> <br />[J STEEL <br /> <br />D OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />CONTI\.AGTORSECTION <br /> <br />BUILDI1lR <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN ~ <br />S IGNA'!juR.E '-fY\~+kA <br />I <br /> <br />Pt40 CO B~-k(c.. <br />STATE CERT OR REGIST # E;f<. 00 fL/ oYer I <br /> <br />COMPANY <br /> <br />E-A6T <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHAN(ICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER I <br />I <br />SIGNATURE <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br />