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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />~-':2 (j~ct;! <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />t3C>.-hv~ <br />b l{ t(O <br /> <br />11-/ v """: V\. v W\ <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />r::- i . <br /> <br />Ie.' 1It.of <br />, , , <br /> <br />I2d, <br /> <br />(?~3 ?~.,)-<(')/r? <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br />(] SIGN <br /> <br />(OBTAIN FROM PROPRRTY TAX NOTIeR) <br /> <br />(] ADDITION <br /> <br />(]ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />(]MOVE <br /> <br />(] DEMOLISH <br /> <br />PROPOSED USE: oSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />oMULT I - FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />oSWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK 11~~~./~_}N1V{h0f\. VMto ftbJ.f) <;~ 6/'" VMiJ <br /> <br />BUILDING SIZE SQUARE FOOTAGE HEIGHT <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 />/ <br />~UILDING <br />/ <br />(] ELECTRICAL <br /> <br />PERMITS REQUESTED <br /> <br />& (1) SET ENERGY <br />FORMS. <br /> <br /> <br />t 0'/' ~ <br />7")' , <br /> <br />FORMS. <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />--------) \ <br />o ..R.y:: 1)) <br /> <br />~/ .~/V// <br />iF .' '/ <br />OF MECHANCIAL INSTALLATION <>'./ <br /> <br />FLORIDA POWER <br /> <br />(] PLUMBING <br />(] MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />(] ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: (] BLOCK <br /> <br />(] FRAME <br /> <br />(] STEEL <br /> <br />(] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAo YES 0 NO <br /> <br />SIGNATURE V ~ f3~ <br /> <br />CONTRACTOR SECTION <br />COMPANY ~ /30... /, r./ /1-1 v &Nt.' H t./ ~ <br /> <br />BUILDER <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 />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 <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />