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<br />OWNER'S NAME <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 U / 'J..-/D tJ <br />DATE RECE IVED ry-, -f- <br /> <br />PHONE CONTACT FOR PERMITTING 9;) - l/ ..:2~~ <br />? 7Cj-c)O/S <br /> <br />ScoH <br /> <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAl DESCRIPTION: <br />C'-~~~L ID.v <br />WORK PROPSED: EJNEW CONSTRUCTION <br />OSIGN <br />PROPOSED USE:~ FAMILY DWELLING <br />o COMMERCIAL <br /> <br />SUBDIVISION <br /> <br />_~~~~~ PROPF.RTY TAX NOTICF.) <br /> <br />~--:-,,;,;;;:";"';'.,---._--._-. <br /> <br />o ADDITION <br /> <br />o ALTERATI ON <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />~ALL <br /> <br />o MOVE <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />& HEALTH <br /> <br />1'<..( <br /> <br />SQUARE FOOTAGE 4"., 15110 51(/ <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS &~) SET <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 />BUILDING SIZE <br /> <br />o BUILDING <br /> <br />$ <br /> <br />;20D ~ <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PL~ING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 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 AREAO YES 0 NO <br /> <br />CO~CTORS:&:CTION <br />BUILDER A · . ~ . . COMPANY O/G?-J-f../4) <br />SIGNATURE }./// },,)('t/I..# PLd...t.J <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRJICIAN <br /> <br />COMPANY <br /> <br />SIGNATpRE <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 />