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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TB St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br />r::> DATE RECEIVED <br />C5 ( .:S 3 s-s- / 3d S~ <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ST.e {J h.(J /7 <br />I <br />JOB ADDRESS ~1-j/ 0 <br /> <br />E. <br />q'lh <br /> <br />j / g~ 3 '") <br />tf uS Ski PHONE.:5 S S <br />S'T r -t>.e 'T) '2 -f"ph <..,jr)~ Ills , <br />/ / <br /> <br />1.$06 <br />rz 3 '5 S Cfd. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />[J ADDITION <br />o MOVE <br /> <br />[JALTERATION <br />[J DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />/ Lj I X d- c9 I COr C V -f T€ S L4h ll2m'7 (;A:J1.A-f,..(/ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />[J BUILDING <br />[J ELECTRICAL <br /> <br />$ <br /> <br />I <br />/ J 000 <br />'j <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J PLUMeING <br />[J MECHANICAL <br /> <br />$ <br /> <br />[J GAS <br /> <br />[J ROOFING <br /> <br />[J SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 AREAD YES [J NO <br /> <br />C:()~QT():R$:&:eTION <br /> <br />BUILDBR '. '\ I <br />SIGNA~ ['.'--tt~ <br />/ <br /> <br />COMPANY <br /> <br />C;e).-! <br /> <br />STATE CERT OR REGIST # <br /> <br />********************************************************'k********* <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 />SIGNAWRE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REG 1ST # <br />