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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 RECEIVED <br /> <br />1-~-[)Lj <br /> <br />PHONE CONTACT <br /> <br /> <br />PHONE r <br /> <br />OWNER'S NAME <br /> <br />j)1t tI2/:)T€-t.. Th~ c:t- ~-res <br />?6 aq t:A-Ll.- Eb/i) <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />~C?~~ <br />WORK PROPSED: []NEW CONSTRUCTION <br />~GN <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPF.RTY TAX NOTICE\ <br /> <br />o ADDITION <br />o MOVE <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />~THER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />... <br /> <br />~/c1N~ ~ - /?llf71~.a.-../ /.0.dL~ <br />. SQUARE FOOTAGE HEIG T <br /> <br />BUILDING SIZE <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 />~ING <br /> <br />PERMITS REQUESTED <br /> <br />~ 3t~~ <br /> <br />$ <br /> <br />v. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br />g9~Q~s(smC;TIQN <br /> <br />BUILDER ~ ~ COMPANY .///{tt/ ,c/etu1>A- '! rJfS "':/:d'~h 't:.S <br />~ /l~ ' ~ i)t-y!'u..-. ~ [) . . <br />SIGNATURE V /~ ~ STATE CERT'foR REGIST * r <br /> <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br />SIGNATURE X <br /> <br />C? . <br />~~. /L-, <br />, ~J <br /> <br />COMPANY~ u '1 t ~Vj ~ <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 REGIST # <br />