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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 />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME r ;'~/V .5{ ~ J t2rr tv (2.. ~ <br />-- I <br />JOB ADDRESS ~BOf AIlt?oi:l ~1Jh{ ~ <br /> <br />4/ ;(19 <br /> <br />PHONE -Zl2 -/7~7 <br />Z?i>fI~pt.. f/ 5 <br />I <br />SUBDIVISION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />I 'J ,.~(.~ ;J.,(. 01 J 04 0 02.0D ~ 2., 9 0 <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION [J ADDITION [JALTERATION [J REPAIR [J INSTALL <br /> [J SIGN [J MOVE [J DEMOLISH <br />PROPOSED USE: [JSGL FAMILY DWELLING [JMULTI-FAMILY [J# OF UNITS [J MOBILE HOME <br /> [J COMMERCIAL [J INDUSTRIAL [J SWIMMING POOL [J OTHER <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />BUILDING SIZE <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />If?(~ (;~C-t/S(~ I./Mrf <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 & (l) 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 />[] ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />[] PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />0.;;;) <br />/0'10' ;-- <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[] OTHER <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES [] NO <br /> <br />C()~~~.._..iSEC'1'ION <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 /> <br />STATE CERT OR REGIST # <br /> <br />...........~;;.;;:;;/..*(]~fc*;/J(*.;y6 . U-C <br /> <br />STATE CERT OR REGIST # c;tccJf/-z..( t. 7 <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />