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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 RECE IVED <br />PHONE CONTACT FOR PERMITTING ~13'1~~.C)0'1\ <br /> <br />OWNER'S NAME ~i'1 ~(:. ~phlVbi.lJ~ PHONE <br />JOB ADDRESS~I~eJ Lo..ne -Z.ph.y.iliJlc;j I=L. ~3S-l:L- <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL ID # \~ .~\c . aa . 00 Ie. O'6bDO. 000 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />[J SIGN <br /> <br />[JADDITION <br />[J MOVE <br /> <br />o ALTERATION <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERC IAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~dd ()ew ~ljVltL ~ -eJ(i~:J;n~ bJ~k:\ln~ (~c.H'--k bJf\W\ 2.oo~ <br />u f"ld~ ~ ~ ':"")4 ~"Il ( LQ.. . <br />SQUARE FOOTAGE HEIGHT <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: A'rTACH (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 CONSTRUC'rION. <br /> <br />PERMITS REQUESTED <br /> <br />[J BUILDING <br />~ ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />2e 0 AMP SERVICE )tJ <br />Va.lUtL-hoV\ ~qOO. 00 <br /> <br />FLORIDA POWER <br /> <br />[J <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INS'l'ALLA'l'ION <br />o OTHER <br /> <br />TYPE OF' CONSTRUCTION: [J BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />[J NO <br /> <br />r--I--- <br /> <br />C~W'I!'j'--\'""".*.D' '.' .... <br />.: ~1'!11'1~f\~~~1i@I'_.Jt.~ <br /> <br />71 <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br />SIGNATURE l~~ 3- k <br /> <br />COMPANY "R€-Q.5-.C- ~I e ch--; u..I, ~. <br />STATE CERT OR REGIST # EC-. \ ~c:Dl ~s~ <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />