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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 e9 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />OWNER'S NAME <br /> <br />Cu~ <br />(!> 0 ~ ~ <br /> <br />S a.Y-C.V~,k(,<;. Ov- A\'\+~c.,~ ~l-j),IIJ;"O~ <br /> <br />~ \.k~ 2 l.- phi'" l{.1\'j, <br /> <br />~~ \1 <br /> <br />DATE RECEIVED 5/7 / bL <br />{ I <br />PHONE CONTACT FOR PERMITTING )?"l1 ~ ~'O-'84.(P0 <br />/27 bt.{ 3 - ~tl LG.- <br />PHONE 7'17: 450 - (q 17 <br /> <br />R.. I 3 '!,)' l.{ '2- <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # 03-J(,-~I-OOI0~ \2.~o()-OOOO <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPF.RTY TAX NOTTeF.\ <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />~IGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />DCOMMERCIAL <br /> <br />D ADDITION <br />D MOVE <br /> <br />[JALTERATION <br />D DEMOLISH <br /> <br />D REPAIR <br /> <br />[J INSTALL <br /> <br />[JMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />[J# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOBILE HOME <br />DOTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK , \Il s tp.,1 \ 4 'Yl~o-x SLj 1/1 /i~~U. & ~ V\ <br />BUILDING SIZE SQUARE FOOTAGE <br /> <br />Nw ~ B.;. IJ:h) .~ <br />HEIGHT dOl <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />--r <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />.." <br /> <br />'3 ~, ov <br /> <br />J~U) G <br /> <br />PERMITS REQUESTED <br /> <br />-'f"'" <br />~}'> . <br />" <br /> <br />6~ <br /> <br />I F Ll 'flT}~ <br /> <br />[J BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />[J PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />if~oS~ <br /> <br />/ <br /> <br />D GAS <br /> <br />[J ROOFING <br /> <br />[J SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />cq~gT()~!SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />********************************************************'k********* <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 /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER S \ ~ .., . C /7'-I-tVllo 190...... <br />s rGNATURE (~ \..t l~.w....." ,":::""4.. "'. ~I'" t <br /> <br />COMPANY KOj~r.s ' S ~ J In COlTf <br />STATE CERT OR REGIST # Es <br />