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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 89 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 l;j.e&{;~ ~~il;~'t!;J-/YIM;;to <br />JOB ADDRESS '-<-.~~~S \\~"1~-:-N'--'iI. ,~~~ <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />PHONE <br />\ ~~ ~ ~, <br />- ~~ \\\~';.6f>\..,,^- <br /> <br />SUBDIVIS ION \ <br /> <br />\\Q. V", <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br /> <br />o ADDITION <br /> <br />DALTERATION <br />[J DEMOLISH <br /> <br />o REPAIR <br /> <br /> <br />[J MOVE <br /> <br />[JMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />[J# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />[J OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~-..Sl ^" ~ <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 /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[JGAS <br /> <br />o ROOFING <br /> <br />[J SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />o STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES 0 NO <br /> <br />C.ONTRACTORiSECTION <br />...' ......'... ":",', '''.'' ....., "", :.' .. .." .'. <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 />~ J ~ COMPAN!:",~",~,-<., \ ~~~'l\~~\'~~ <br />. , l (y~ ~~ STATE CERT. OR REGIST # ~~C\ll~~<k,c\~ <br />$ )OZO ' <br />******************************************'*********************** <br />COMPANY <br /> <br />SIGNATURE <br /> <br />MECHANICAL <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 />