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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 RECEIVED <br /> <br />3-/7' ({IV <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME -1A.) j ll; tlVY\ C (a5 ~.:e_ <br />JOB ADDRESS 37J.fOJ... Dp-r6ish,;"'e..,. 'D.. <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL 10 # 'D-~b-,;1I-0l;;W-COO'XJ-10l{O <br />WORK PROPSED: (JNEW CONSTRUCTION ~ADDITION <br /> <br />PHONE <br /> <br />SUBDIVISION t.u e~eu..y:~.)&.. <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />(J SIGN <br />PROPOSED USE: ~GL FAMILY <br />(J COMMERCIAL <br /> <br />o MOVE <br /> <br />DALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DWELLING <br /> <br />(JMULT I - FAMILY <br />o INDUSTRIAL <br /> <br />(J# OF UNITS <br />o SWIMMING POOL <br /> <br />(J MOBILE HOME <br />(JOTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />/Sr'f'pen RoiJ7"n 60 !::~X-lc;.T/fj~ SLA~) <br /> <br />BUILDING SIZE <br /> <br />~)('5 <br /> <br />SQUARE FOOTAGE <br /> <br />I d-.O <br /> <br />HEIGHT ~ec,. Pel... ~ <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 />~BUILDING <br />(J ELECTRICAL <br /> <br />$ Z- c;oo , Of) <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />(J FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PL~ING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: (J 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 AREAD YES 0 NO <br /> <br />SIGNATURE <br /> <br />~)h~M <br /> <br />CON'rRACTOR....SECT..ION <br />i,.....:.:'..:, , ',_, .,....:.::._,;:...:..(..._....:.,..._., ,_....'_, . <br /> <br />A--i <br />COMPANY .J . 50 <br /> <br />COY\.S.t'Ue-f, D"'-' <br /> <br />BUILDER <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 />********************************************************~,******** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />