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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 RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME C" I 'r~ <br />I <br />JOB ADDRESS (" " r c.; <br />/ <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />o /' 21:-/J '7",/1. -/Is <br />f1q /2..<J <br /> <br />PHONE <br /> <br />7/f/- k2'17 <br /> <br />S<'''LIY-h five - <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br />o SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />(ORTATN FROM PROPERTY TAX NOTICE) <br /> <br />~ITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[J MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />..z: A./SrA// <br /> <br />#(.4../ <br /> <br />A " "/2... <br /> <br />C t1A/ Al';' c,..., " __ ,:,. <br />I <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 />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[J GAS <br /> <br />o ROOFING <br /> <br />[J SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br />CONTRACTOR........SECTION <br />',-'.'.'_...... ....:-,....-:-.)..,..:.....>>.,..:.,:.....-,'.,..'.. . .:':-' ".... <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <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 />MECHANICAL <br />SIGNATURE ~./ ~ <br />/' <br /> <br />****************************************************************** <br /> <br />COMPANY t!f/ A I/~ ~ h ~A';- l. c: A.s R 7(/C <br />STATE CERT OR REGIST # C.4 L ttJ Y .3? Y g <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST!f <br />