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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER' S NAM~ 4,. ,(j <br />JOB ADDRESS LI D l:( Lr <br /> <br />;Jbb(jf--t-- <br />/ 7 ~ 5+ <br /> <br />II j-I 7(;" o~ J,).. 7 ~ <br />PHONE C' 9n?- 1710 <br /> <br />2~pL,/~: '\5 <br />, <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: []NEW CONSTRUCTION <br /> <br />D ADDITION <br /> <br />DALTERATION <br />o DEMOLISH <br /> <br />D REPAIR <br /> <br />[] INSTALL <br /> <br />DSIGN <br />PROPOSED USE: []SGL FAMILY DWELLING <br />DCOMMERCIAL <br /> <br />[] MOVE <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />D# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOBILE HOME <br />bT~R <br />3lteq <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />Sh~d <br /> <br />BUILDING SIZE / J ~ /6 <br /> <br />SQUARE FOOTAGE /9~ <br /> <br />1=f- <br />HEIGHT '8- <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 />D BUILDING <br /> <br />$ ,,)00 S&- <br />/{/1-- <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />FLORIDA POWER <br /> <br />[] <br /> <br />W.R.E.C. <br /> <br />D PLUMl3ING <br />D MECHANICAL <br /> <br />$ <br /> <br />f7 /~ <br />t' <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br />~RAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />o GAS <br /> <br />D ROOFING <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES ~NO <br /> <br />CONTRACTORSECTIOl'l <br />" ........,.' .. .. ,': "," ,;.,.. "..-.. -"-"" ,:.- .. .-), <br /> <br /> <br />BUILDER ^ eL- ~___ <br />SIGNATURE /;6 M ~ 0t.L-<V1 ~-~ <br /> <br />COMPANY <br /> <br />() tJN/t <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />IJ CJ VI (::!"' <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNA'TIURE <br /> <br />t1 0 (,1 (~ <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />********************************************************~,********* <br /> <br />COMPANY <br /> <br />SIGNATIuRE <br /> <br />U C') M /!:- <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATtmE <br /> <br />STATE CERT OR REGIST # <br />