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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />Lf-Icf-oy <br /> <br />PHONE CONTACT FOR PERMITTING ?( J - J 7 r., - 2 2 73 <br /> <br />OWNER'S NAME ),t1vy-<.Jlq 'vvo..{fv,'v1 <br />I <br />JOB ADDRESS )002 I J- -li 5f, <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # 1(- 2~ - 2( -DO'()-OnOO -olio <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br />[] SIGN <br />PROPOSED USE:~SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />[] ADDITION <br /> <br />[]ALTERATION <br /> <br />Ja'REPAIR <br /> <br />[] INSTALL <br /> <br />[] MOVE <br /> <br />[] DEMOLISH <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBILE HOME <br />[] OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK /1aJ~ wa..I<1r c1a.....j~) 17",4.1'(.. 11c.,.~) ,Y'f.J..-i-.'"..} <br />BUILDING SIZE SQUARE FOOTAGE SUO <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 /> <br />19" BUILDING <br />[] ELECTRICAL <br /> <br />$ <br /> <br />70 )2- . 7] <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />[] PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES [] NO <br /> <br />C. OlmUtJ. '. ,'. ....,...... C....!l'O........R. .'.,.,\,..$.. '.E.C.' TIO. N <br />',,' ,',', .......':.."..........,. ....'.. ",'-;'.."', '." .. .." <br /> <br /> <br />p,. ';t:;,-fr.... /(1 ~ ,,",A. r.( <br /> <br />SIGNATURE <br /> <br />L&~ <br /> <br />STATE CERT OR REGIST # (C-c 0 7~fYj' <br /> <br /> <br />BUILDER <br /> <br />****************************************************************** <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 REG 1ST # <br />