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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 />V'f (. I~ /~ '!o<' ,.J.' PHONE CONTACT FOR PERMITTING :J5J...-<j2l..;....O/L/j-' <br />q I 1 lfVoC( ) ej vi l-e ~ .., " f. _ <br />. 1 '. /7. .' /J ..j he ___ C/j.~'") Lti.~eIJq(,)flJ ..bt, <br />OWNER' S N~ ChtZi;/ l2lr;eifc. l~V5TR.u(j(u,J. <:/Nv PHONE 35)_..~.2.3-GV~ <br /> <br />JOB ADDRESS 191..0 f 'ff22 /J.~IlfJLT R i) ~2,J..I; II <j J-::'L, -SsL- 'I2.V- Of <((j"'- <br /> <br />I <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # /3 - 4-01../- O{)/.J. {)(}c.JocJ.- () / U <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED:9JrNEW CONSTRUCTION <br />OSIGN <br />PROPOSED USE:OSGL FAMILY DWELLING <br />~OMMERCIAL <br /> <br />o ADDITION <br />o MOVE <br /> <br />(ORTAIN FROM PROPERTY TAX NOTICE) <br />:f'N1'miJ/L <br />Ji(1ALTERATION 0 REPAIR 0 INSTALL <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS 0 MOBILE HOME <br /> <br />o SWIMMING POOL 0 OTHER 1'" <br />-:f',/(ell ~J11 /::=tUJW1t.:!uVo <br /> <br />(3't;'}.?/-I: 1JiAf) <br />/7~ <br /> <br />HEIGHT <br /> <br />o RESTA~T & HEALTH DEPARTMENT A!?PROVAL <br />, . '.../:)J(J2. IJ.l(Il-"('I~IL ~(e.JI1'\1 <br />DESCRIPTION OF WORK {3i./',dcl 3 fr<<e..s.k. I tJfI~((J5 -.J-IJ5.dtt Sftc../ <br /> <br />BUILDING SIZE '1Jl/ x: <1'1- SQUARE FOOTAGE )./-1/3 -:a <br />EX/,:trj,)G 1tV-.-/lO/nJ& L'5t.;SjiA)G ,5'77l....,\GTWltJ <br />~ESID ~~ ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET <br />~~~I~ ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />F SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />ENERGY FORMS. <br /> <br />r;{BUILDING <br />fiY' ELECTRI CAL <br /> <br />II o.J PERMITS REQUESTED <br />$ 1'7 900::::.::;:....-' VALUATION OF TOTAL CONSTRUCTION <br />I <br /> <br /> <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />(/~ / 51 <br /> <br /> <br />// <br />\ / <br />'---..-- ------------/ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />IiY' FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />~ <br /> <br />SIGNATURE <br /> <br />~~ <br /> <br />C()N~q!1'O:RSECTIQN <br />COMPANY chI'; <br /> <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />C~( -(J5d 171(p <br /> <br /> <br />************************************************************ <br /> <br />:e.. COMPANY iJ (,f0;:r f (( ("1? /<' <br />e:... t' -?--- STATE CERT OR REGIST # ~:?LJ(J I e'er 7' <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />~~~ICAL <br /> <br />SIGNATURE 'f:' <br /> <br />*********************************************~**********~***** <br /> <br />() COMPANY :/0 ~"t/~ <br />~.~ ~7 ~ STATE CERT OR REGIST # ~H1 00 t r<Ut> <br /> <br /> <br />******** ******************************************************** <br /> <br />I <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST #, <br /> <br />. <br /> <br />" \,>1: <br />. ... <br />., .,' <br />