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<br />~Vv9:OI -g 'H~ aW!l <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPAR~N~ 5335 8~ St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />pa^!a~aH <br /> <br />DATi: ImCEIWD <br /> <br />g ~ /O-tJ1 <br /> <br />paONE comAC~ FOR PERMITTING <br /> <br />OWNER'S NAME J(\mm ~\ ~ ltC- <br />JOB ADDRESS M;;l~~\ ~~ *' Jute~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PHONE <br /> <br />~(:)()1\ ~\\icl ~ 7~h1~'1\\~ U3W <br /> <br />SUBDIVISION <br /> <br />PARCEL ID * <br />WORK PROPSED: ~W CONSTRUCTION <br />o SIGN <br /> <br />(OBTAIN FRpM PROPF.RTY TAX NOTICE) <br /> <br />o ADDITION <br />o MOVE <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USEl (JSGL FAMILY DWELLING <br />~MMERCIAL <br /> <br />(JMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0* OF UNITS <br />o SWIMMING POOL <br /> <br />(J MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & H~TH DEPARTMENT APPROVAL <br /> <br />""SCRIonON or woaK -=fu~I1~10f1ly\\re- S~(I~~JY\yu J\)r~ <br /> <br />BUILDING SIZE ~ <\nr~ SQUARE FOOTAGEJl.Q) {cjlt;st(.t't 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 />PERMITS REQUESTED <br /> <br />(J BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />~ECHANICAL <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION <br />o OTHER <br />~RAME <br /> <br />tlre '5V( l(\~e.r . 1..- <br />OF MECHANtIAL INSTALLATION 501 <br />~PD?"" <br />(::::r~ -1 ') <br />o OTHeR <br /> <br />$ Qd. {::/~ I <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />o STEEL <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CeRT OR REGIST * <br /> <br />****************************************************************** <br /> <br />ELEC!'RICIAN <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 />COMJ?ANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br /> <br />***************************************************************** <br /> <br />COMPANY :!f\kJ~O()Q \ tlfQ... \t~On <br />STATE CERT OR REGIST tlJ.l5', D l oc::o II <1~ <br /> <br />r\JQ.. rU~()n <br />O'1!JZR <br /> <br />SIGNATURE <br />l~ <br /> <br /> <br />066v'ON <br /> <br />SllIH~AHd3Z :10 Al/J.____...V1Vy9:6 .,.VOOl -g 'HVI <br /> <br />. <br />. <br />. <br />. <br />. <br /> <br />I - d <br />