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<br />'""- <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aD St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 ~ <br />DATE RECEIVED v. /6 - b<f- <br /> <br />( :5kPiI/~ m/J/ ~$fc:;fe~ .::tIJc) <br />OWNER'S NAME C~~J ~JUd. C~He~J~ PHONE t9{; -9~ <br /> <br />JOB ADDRESS~/4-l (~_12&. S4- Bisj- 2:CPht,~.u';/'{~ FA... '] Jf: +;)- lor 5 <br /> <br />LEGAL DESCRIPTION: LOT IS) 1<0+ 5 BLOCK SUBDIVISION '5I.ee;J" /f../ln.v- J]::, <br /> <br />PHONE CONTACT FOR PERMITTING ~ 75- 1q1~ <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTIC-F.l <br /> <br />EJ ADDITION <br />[J MOVE <br /> <br />[JALTERATION <br />[J DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME' <br />[J OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK /0 x 54- P;<:H? h Il- )t,/I-;,., 9- <br /> <br />BUILDING SIZE SQUARE FOOTAGE 34-0 ~ j:i:- <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />[J BUILDING <br />[J ELECTl\ICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />$ <br /> <br />/ j 00 ,0-0 <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[JGAS <br /> <br />[J ROOFING [J SPECIALTY <br /> <br />[J 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 AREA[J YES [J NO <br /> <br />c:()~g~R.iSECTION <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 />SIGNATU~E <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br />SIGNATURk <br /> <br />COMPANY <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 />.' I <br /> <br />OTHER 1'a>161d-.r._ ecm rfi-Ad ~^- <br />SIGNATUR~ ~,,"";/A <br /> <br />***************************************************************** <br /> <br />COMPANy,R:Sr'''' /.I? (l ~ /J14-&fttd1 :) Pc ~ <br /> <br />STATE CERT OR REGIST # /:H)('-,e; O<J9"i"/ <br />r . <br />2 - l-(rfc.5 i'7L9:::> <br />