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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 />PHONE CONTACT FOR PERMITTING <br /> <br />--~----,--- <br /> <br />OWNER'S NAMF:~hO;(1r ~~Y") <br />JOB APDRESS .3~; 'Dy.. tf ~ ~ <br /> <br />PHONE <br /> <br />,/ S- - DeJ.'? 0 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # -1f -~ {~ ~J.{.. QOID - II ;}.[J ~ - ('Jd-.O J <br />, <br /> <br />(OBTAIN FROM...EROPERTY T.8.X~ <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />OSIGN <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULT I - F'AMlL Y <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SW IMMING POOL <br /> <br />o MOBILE HOME <br /> <br />o <br />OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D <br />(s'l3 P <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~~------_._. <br /> <br />SQUARE Foo4AGE <br /> <br />BUILDINC:; SIZE <br /> <br />HEIGHT ____ <br /> <br />RESIDBNTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <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 />& (1) SET ENERGY FORI1S. <br />FORMS. <br /> <br />?~?- <br /> <br />,j 0' <br />q, 5f T. <br /> <br />PERMITS REQUESTED <br /> <br />o 8TH LDING <br /> <br />$ <br /> <br />...,--- VALUATION OF TOTAlJ CONSTRUCTION <br /> <br />o ELEcI1RICAL <br /> <br />-- AMP SERVICF: <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMaING <br />o MECHAjNICAL, <br /> <br />$- <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OiF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISH~D FLOOR ELEVATIONS <br /> <br />IS PRO,JECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br />I I CONTRAOTOR"slcm:tON I <br /> <br />-:;'::::~E--..'--~~~L~" :~:::;~2~~?::;~i~~. <br /> <br /> <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 />MECHANtCAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATORE <br /> <br />I <br />I <br />SIGNATURE <br /> <br /> <br />. -~:,. " , :\~ l.or: <br />t'lt(i;c,.". (', f. ~, .', """~;fr (10"', ..,' . )...~ <br />... "',' ,-.... , ~ .,~.~.' : '-'.r "";"'~\'n~~'."~:t <br /> <br />STATE CERT OR REGIST # <br />""-1~~..Jo,~"...........~.... " <br />* * * * * * * * * * * * *:; ~(d*'\..~~i~'***~.,~'~4:,~';:*";;~J'~ 1 <br />nJMDt\~T.L- /, i:')t--:" <br />.'_ L_~~' . '. ,. .~,... !' <br /> <br />OTHER <br /> <br />.'~~'-"'"-~~''',P'~I~J-'.~~~~ <br /> <br />STATE CERT OR REGISf # <br />