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<br />CITY OF ZEPHYRHILLS PBRMIT APPLICATION <br />BUILDING Oi.PARTMENT 53,15 8'l'1I St, Zephyrhills, n 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />OATi: RECEIVED <br /> <br />-9 'i () <br /> <br />i L.' 1 <br /> <br />PHONE CONTACT FOR. PERMITTING <br /> <br />OWNER' S N;u..l~~ <br />JOB ADDRESS 3<g~.).. 9 <br /> <br />LEGAL DESCRIPTION: 1UT(S) <br /> <br />s'f-1n <br />I 5 BLOCK \ 5 g_ SUBDIVISIon C~+~ f <br />ll-:}tp -~\ -0010- I~~O -0 ISD <br /> <br />Mber-+ S <br />Ave <br /> <br />PHONE ~:J.J..L\ <br /> <br />PARCEL 10 # <br /> <br />z..-hd Ls <br /> <br />WOHK PROPSED: 0 NEW CONSTRUCT'10N <br /> <br />o ADDITION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br />~TERA'rION 0 RfPAIR 0 INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED OSE: OSGL FA1-1IL'l DWELLING <br />~MMERCIAL <br /> <br />DMULTI-FAMILY <br /> <br />o it OF UNITS <br />o SWn-1.Iv1ING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o INDUSTRIAL <br /> <br />o RESTAURANT & HE,ll.LTH DEPARTMENT APPROVAl, <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />BtlILDH1G SIZE <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING ?LANS & (I) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERl.H'l' ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROFERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br />~ECTFrCAL <br /> <br />$ <br /> <br />VALUAT!ON OF TOTAL CONSTROCTION <br /> <br />At1P SERVICE <br /> <br />o Progress Energy 0 <br /> <br />ftLR.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUl\TION OF MECHANCIAL lNSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRlJCTION: 0 BLOCK <br /> <br />o FRAt'1E <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS I?FH)JECT 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 />~****************************~****.*******w**********.************ <br /> <br />ELECTR.ICIAN <br />SIGNATU"RE 'iI\~ <br /> <br />~~ <br /> <br />COMPANY fft.sT EA-~(O 8eC~[Cl Trtc. <br />STA'fE CERT OR REGIST # Er:Z. 00 [45<1 I <br /> <br />***********.********.*********w.******************~*************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNA'I'URE <br /> <br />STATE CERT OR REGIST # <br /> <br />HECHAN!CAI.. <br /> <br />******~**************~w~.********~*************+*******.********** <br /> <br />GO!1PANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIS':' # __ <br /> <br />**w~******************~****~*********.*********~**.~*********..** <br /> <br />OTHER <br /> <br />COMPA.NY <br /> <br />SIGNATURE ___. <br /> <br />STA.TE CERT OR REGIST ~ <br /> <br />~-- <br /> <br />c <br /> <br />6 t iJ 9 . i) ~~ <br /> <br />Sll!ri Hd3Z JO A1IJ <br /> <br />~~ZZ:8 tooz 'ZZ'Je~ <br />