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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aD St, Zephyrhills, FL 33542 <br />813-780-0020 FAX,813-780-0021 DA1'E RECEIVEo :1/:0/01/ <br /> <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME '~lt ,(;{l/ <br />JOB ADDRESS j 2- Y <-. <br /> <br />S ItT;re;./ZT /l--r;JA-1 'it;;- <br />A- / fJ L c;C2/j-/, 6- <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # Js' -1.S - 21- (/()S-O -S () 0 () V - 7> l :z~ <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br />PROPOSED USE: ~ FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTIC-El <br /> <br />[J ADDITION <br />[J MOVE <br /> <br />[JALTERATION <br />~EMOLISH <br /> <br />D REPAIR <br /> <br />[J INSTALL <br /> <br />OMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />[J OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />R ~ ~ ;({J O,L/;U (.. <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />"'''''''\. <br />, <br />, <br />. <br />\ <br /> <br />RESIDENTIAL: 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 FORMS. <br />, <br />FORMS. //'" <br /> <br />VALUATION OF <br /> <br />/// ~\ DC/ / <br />(, / <br />,,~ <br /> <br />TOTAL CONSTRUCTION <br /> <br />g/'BUILDING <br /> <br />/'/ <br />$ ~ if 00 , <br />/ <br /> <br />00 <br /> <br />PERMITS REQUESTED <br /> <br />[J ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />...... <br /> <br />[J PLUMBING <br />o MECHANICAL <br /> <br />...- <br />../~. <br />// <br />// <br /> <br />\ <br />\ <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />o FRAME <br /> <br />D STEEL <br /> <br />[J OTHER <br /> <br /> <br />$ <br /> <br />[J GAS <br /> <br />o ROOFING <br /> <br />[J SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLA <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />c.....O...N'rAA.. c. ro....... R. ..............S. EOT. 10. tlf <br />" ..'.' -, .' - - .'.< ,- .....'. ~. ,,- "..- .'. .. .' .'.' .' .'.' .' <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 />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br />.... <br /> <br />{(}c-ff <br />~ <br /> <br />***************************************************************** <br />L ' <br />/'n. ,) f2 OD~~;Jt-:J <br />COMPANY (r"" 1/ ) /L/' v <br />STATE CERT OR REGIST # IE co {) t.J ~2 Lj ) <br /> <br />tit J/~ <br />C-.:.- fJ /J A- <br /> <br />SIGNATURE <br />