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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED b - ~ - ~ (' <br />PASCO PE;RMlr .S'E:RIfI( <br />PHONE CONTACT FOR PERMITTING (-'6c'C(Q-g),L{-.7gQt.j- <br /> <br />Oat/J" tvrriJ" <br />7 3~o f//fj 1- IQ,It d lOOJfJ <br /> <br />V' , <br /> <br />LEGAL DESCRIPTION: LOT (S) J BLOCK <br />3'/- aLS-oLl- O/(J()- O():J()O-OOJO <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />PHONE <br />2€pJjrki/J <br />SUBDIVISION <br /> <br />F I d S)-tj) <br />OO-K R-fL/J <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br /> <br />J;&f ADDITION <br /> <br />(OBTAIN FROM PROPF.RTY TAX NOTIr.El <br /> <br />PROPOSED <br /> <br />[]SIGN <br />USE:~SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />[] MOVE <br /> <br />DALTERATION <br />o DEMOLISH <br /> <br />[] REPAIR <br /> <br />o INSTALL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />o MOBILE HOME <br />[] OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />IS e ree.n /!.()OPJ <br />j rJ. 'f. ~O <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />(.f!~6 - fJa ^- <br /> <br />~<fO 'I <br /> <br />/ Ai >' t:JO <br /> <br />mol- <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />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 />~ic:jP.~ <br />PERMITS REQUESTED <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />00 BUILDING <br />[] ELECTRICAL <br /> <br />$ <br /> <br />il of.> <br />'1, om. <br /> <br />qu, ~~ flttM, <br /> <br />2.'10 ~~~~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING 0 SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />o STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES 0 NO <br /> <br />BUILDER <br /> <br />~i~ we <br />(/ <br /> <br />,.----- -..', -. -, -'- -. -......---.. . . <br />C6~!l'ORihSZCTIC>N <br />~:. '0 .~ ','-" . ;..>' ,; '~, ~ -.': ", .."-,.:;.\ <""~'~' >,;;.-,;,,:,.' '~'<:,-:"'. _ .':.' .;. _ :,' . -,:,' -c.'- .::, <br /> <br />COMPANYU f/ ^ 0 -J <<-Ie <br /> <br />- <br /> <br />AI t!1J<.//J///YJ ,hc. <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 />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />