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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aD St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />PHONE CONTACT FOR <br /> <br />PERMITTING &, -3 q - 7 ~ 3 tf <br />PA..Ut.. L()tJ~6~()P-'1 <br />PHONE 7'8~ ~ 04// <br /> <br />OWNER'S NAME <br /> <br />l;;:4St /)A-':::>W JilQ\,C-4L-C J;::iJl~ <br />70S- D ;';4-LL ~ li/1., <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br /> <br />XADDI T ION <br />[J MOVE <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />[JALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />o SWIMMING POOL <br /> <br />[J MOBILE HOME <br />~THER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />A'tV3ti7f)~ V- ~-,..v;llmnN 1JF l-kx~r17k- .- .fotJ"iNJ-ntYN~ lJIJ!/- <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <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 />AMP SERVICE <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br />Eu=ie-nLJT I~ A;\\O <br />l)l~Y~~. 5 ~.. Ll. <br />r _ ~O YN <br />PERMITS REQUESTED btl-- <3f.It~lU l <br />pJj,lL~ITT0 C~rLn7~ <br />VALUATION OF TOTAL CONSTRUCTION [rStJ""-1L -ro 'TIt") MZ <br /> <br />[J FLORIDA POWER [J W.R.E.C. ~'L~~. <br /> <br />~ SulP".lIVll) plW1.MT <br />t> "f ~ \.."1 Y\.1-lJ} d!:- <br />VALUATION OF MECHANCIAL INSTALLATION flpfL1ui1i....'" rl:f.\. <br /> <br />f (l.JU4I1 J T . <br /> <br />----- ~J 8'S ~ <br /> <br />~BUILDING <br />[J ELECTRICAL <br /> <br />$ <br /> <br />~. DrJO <br /> <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />$ <br /> <br />[JGAS <br /> <br />[J ROOFING <br /> <br />o SPECIALTY <br /> <br />o 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 />BUILDER iiJ um <br />SIGNATURE **:*!....H'...**HH**H*...:~~~:*~:~~*~~*:~~:~*:*:~~~~ 117/ <br /> <br />CONTM,CTOa."SECTION <br />COMPANY Do5lq2 CIJ #;f: C-o~ L-LC:r <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 />****************************************************************** <br /> <br />MECHANICAL <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 />