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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8m St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />~;) 7-Dtj <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME C7 / /rf'/Oo AI 5/fr. 0 I.}- tJe PHONE <br />JOB ADDRESS i..f8o ( A-1It..taJ ~t'r! ('.II ,.,c!.~ t Q J Zft>U,"!t2' ."((j. ~/I' <br /> <br />7 i' ~ -0 c;Jf. l. Y- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # I? -Zc.. LI_n '10./)<<:11 ob-II.~o <br /> <br />(OBTAIN FROM PROPF.RTY TAX NOTICE) <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br />[] SIGN <br />PROPOSED USE: []SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />[] ADDITION <br />[] MOVE <br /> <br />[]ALTERATION <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />[] OTHER <br /> <br />BUILDING SIZE <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />?p.--f! &-C tc- c.." ,..;.1.. Q. ws.. ~ lA. pJ : +- <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />[] BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />PERMITS REQUESTED <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />$ /O'fO'~ <br />[] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES 0 NO <br /> <br />C....ONTRAC!l'O:Rc$EC'l'ION <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 /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />..*.*.*...**.*.*.*.~*.*.*...*~ <br /> <br />COMPANY sJ ff(c4 C.c L <br />STATE CERT OR REGIST # r jtf'i.~ '+'CJc, '7 <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />