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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 /> <br />3 -II - 0 ~ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />, f > 1 (/ <br />OWNER'S NAME c...huv- ch 0 .-/.ht IAJ/ll1j \IV IT d. . _ PHONE <br />JOB ADDRESS 5 d. ~O (O-ih Sf '2e:rh~r h iI/sl F i-.. <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />,gg - 4-5 ~b <br />t3354-0 <br /> <br />PARCEL ID # 11-. dk, - di- 0010.- i g/OD'- DO D <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />Os I GN <br /> <br />o ADDIT ION <br />o MOVE <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />C.h&ztlje wt aM-- -IuMUr. <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMM~RCIAL: 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 />PERMITS REQUESTED <br /> <br />o BUILDING <br />o ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />FLORIDA POWER <br /> <br />------.......... <br />~,/'"- , <br />o W.R.Ef'Y.; <br />~ql& <br />1; -. <br /> <br />INSTALLATION ~ <br /> <br />o PLUMBING <br />~ECHANICAL <br /> <br />$ <br /> <br />/050.0'0 <br /> <br />VALUATION OF MECHANCIAL <br /> <br />o GAS I 0 ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 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 0 NO <br /> <br />[ I <br /> <br />. __.__J______________ <br /> <br />~O~~"Q~I!;zl;$.~m~~ <br /> <br />...---.--___.__J <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECT~ICIJ\N <br />I <br />SIGNA~URE <br /> <br />COMPANY <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 />SIGNATURE <br /> <br /> <br />MECH1\NlCAL <br /> <br /> <br />************* ************************************************** <br /> <br /> <br />~ <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER I COMPANY <br />SIGNATURE STATE CERT OR REGIST # <br />