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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8u St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IWD <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />/l{;: ..q- A /5". -IrA v. ~~ ' <br />'7G ij~ LJ4rf', t.... D'-. <br /> <br />PHONE <br /> <br />'779- %5&2- <br /> <br />JOB ADDRESS <br /> <br />UytJJt...jf' h, '/5 <br />, I <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />2--/ - "7--'=:>-1<5: - 6 J 60 - OOOO() --oIS'O(ORTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />D SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />D ADDITION <br /> <br />[JALTERATION <br />D DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[J MOVE <br /> <br />[JMULT I - FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />DOTHER <br /> <br />D RESTAURANT <br /> <br />DESCRIPTION OF WORK <br /> <br />R,,~ <br /> <br />& HEALTH DEPARTMENT APPROVAL <br />5/1, /Uti /-r:.5 <br />/ <br />SQUARE FOOTAGE <br /> <br />--- <br /> <br />l't ~ <br /> <br />3J ,,_ .QAF <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) 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 />[J BUILDING <br />[J ELECTRICAL <br /> <br />$ <br /> <br />PERMITS REQUESTED <br /><'1 '2.. 7<:::./", ~ ~ <br />'^-..L ./ VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />[JGAS <br /> <br />[J ROOFING <br /> <br />[J SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />CO~qTO:RSECTION <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <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 />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />It-/Y~ ,- <br />~f'~~-- <br /> <br />COMPANY <br /> <br />5'c ~ IT ;-V4{'P ___,. A./ /?-4~ ',A/~ <br />/' <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # ccc.o~'11~? <br />