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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 tVED <br /> <br />c- I' C-~ 'I <br />. <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />6((/"'l4 /'1/f~ie- /11"0# <br />396f6' /1?e7~0 0C~/f <br /> <br />J OCr'/ <br />, <br /> <br />PHONE 8r'-6~;2 7'-6-~Tc-~ <br />'- y ~ ~--, <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: []NEW CONSTRUCTION <br />[]SIGN <br />PROPOSED USE: []SGL FAMILY DWELLING <br />[] COMMERC IAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />[] ADDITION <br /> <br />[]ALTERATION <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />[] MOVE <br /> <br />[] DEMOLISH <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />0# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOB I LE HOME <br />[] OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~,u II ,//9t<'-1/ ~/(/c-//l'l"L"/ <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 />[] BUI LDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />/- <br /> <br />~UMBING <br /> <br />! ;}-d-1, --- <br /> <br />[] MECHANICAL <br /> <br />$ <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[] 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 AREA[] YES [] NO <br /> <br />CQNTRACTO:R,SECTION <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 />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />~/.~ /1/ <br />OTHER~.F1 P: /)':..z...c"'o?~ 5' <br />SIGNATURE ~~ <br /> <br />***************************************************************** <br /> <br />COMPANY /7'IJ[,//c- d- &Y/'c~,.o./~ .l''74/_ >>/),../!~ <br />/ <br /> <br />STATE CERT OR REGIST # <br />