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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 .:<. _ 15 ' 0'4 <br />DATE RECE IVED <::J <br /> <br />PHONE CONTACT FOR PERMITTING ~ I ~ - g 0 'I ~ 0 9 0 c:< <br /> <br />JOB ADDRESS <br /> <br />3C)d.31 <br /> <br />VlV/Av-J L. '1{'C.HARJ~S PHONE ~\3-qtol., (r,qo:;z <br />3 f<D AYE 2-6PHL/R.1IY-lS I ~FlA. 33 S 4 ~ <br />SUBDIVISION ZEpJ.l~ R H&/~H7S <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT (S) I ell( 110 BLOCK <br />PARCEL ID # I~ -~to -;),} - Qay.Q ~ C)ClCoOCl- \:)CJ <.:,0 <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION <br />(J SIGN <br />PROPOSED USE: (JSGL FAMILY DWELLING <br />(J COMMERCIAL <br /> <br />(ORTAIN FROM PROPERTY TAX NOTICE \ <br /> <br />(J ADDITION <br />(J MOVE <br /> <br />(JALTERATION <br />D DEMOLISH <br /> <br />(J REPAIR <br /> <br />l( INSTALL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />(J# OF UNITS <br />D SWIMMING POOL <br /> <br />(J MOBILE HOME <br />Ii? OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK INSTALl- <br /> <br />, <br />BUILDING SIZE ~ ~ ~' <br /> <br />.s7"o~~( sH~ <br /> <br />SQUARE FOOTAGE <br /> <br />",qS~ <br /> <br />HEIGHT <br /> <br />)?'tf" <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 />(] BUILDING <br />(] ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />(J PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D GAS <br /> <br />(J ROOFING <br /> <br />D SPECIALTY <br /> <br />J( OTHER <br /> <br />TYPE OF CONSTRUCTION: (J BLOCK <br /> <br />(J FRAME <br /> <br />(J STEEL <br /> <br />~ OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES )Q NO <br /> <br />CONTRACTO~\SECTION <br />BUILDER~. _.~ ~f( · . COMPANY ({)wJF~ <br />SIGNATURE STATE CERT OR REGIST # <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 />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />