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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/(-(;-0 f <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />SA: J <br /> <br />.- <br /><;'1'1'1 / fI <br /> <br />~Jt--I af5 <br />2<!/Jli,h : IlJ <br />, <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />{OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />WORK, PROPSED: [JNEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />D ADDITION <br />D MOVE <br /> <br />DALTERATION <br />[J DEMOLISH <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />[J# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />{te:\t'?of <br /> <br />S )/,'9// 5 <br /> <br />/ <br /> <br />155~ <br />t/ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />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 />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br /> <br />~UILDING <br />o ELECTRICAL <br /> <br />$ <br /> <br />----- <br />2'A75p'-c <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL <br /> <br />D PLUMBING <br />[J MECHANICAL <br /> <br />$ <br /> <br />D GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />'" <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />o FRAME <br /> <br />D STEEL <br /> <br />o OTHER <br /> <br />FINIsaED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />C()~C1'()R>$ECTION <br />.'.' ....',. ,"H"'_ ,'.;,... ,_' .'.' .,".' _.',' . <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECT!IlICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNA'11URE <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 I ~ <br />SIGNA~URE _ _ __ _ <br /> <br />COMPANY ~ t"ir /"5lAcL<<",N' ~A:';/ <br />STATE CERT OR REGIST #_ CC,-~f7 rS-7 <br />