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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 />PHONE CONTACT FOR <br /> <br />DATE RECE lVED <br />PERMrTTIN(~ )5dl-Lf977 <br /> <br />PHONE (g, 3) '7 g1 - ;3d10 <br /> <br />Kei+h ' \!J~JLJ~ <br />5731 lOth Sf <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL ID # II-a" -al- 0010 - 05500 - 0030 <br /> <br />Uph~151 FL <br /> <br />BLOCK SUBDIVISION <br /> <br />JOB ADDRESS <br /> <br />(QBTlUN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION <br />(J SIGN <br /> <br />(J ADDITION <br />(J MOVE <br /> <br />(JALTERATION <br /> <br />[) REPAIR <br /> <br />(] INSTALL <br /> <br />(] DEMOLISH <br /> <br />PROPOSED USE: (]SGL FAMILY DWELLING <br />(] COMMERCIAL <br /> <br />(]MULTI-FAMILY <br />(] INDUSTRIAL <br /> <br />(]# OF UNITS <br />(] SWIMMING POOL <br /> <br />(] MOBILE HOME <br />(] OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <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 />(] BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />(] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />(] FLORIDA POWER <br /> <br />(] W.R.E.C. <br /> <br />(] JLUMBING <br />MMECHANICAL <br /> <br />$ <br /> <br />3f100,oo <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />(] GAS <br /> <br />(] ROOFING <br /> <br />(] SPECIALTY <br /> <br />(] OTHER <br /> <br />TYPE OF CONSTRUCTION: (] BLOCK <br /> <br />(] FRAME <br /> <br />(] STEEL <br /> <br />(J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA(] YES (] NO <br /> <br />CONTRACTOR 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 />SIGNATURE <br /> <br />COMPANY <br /> <br /> <br />~.. ..~..... ... ..S.:~:: .:::: .::.::~:::.:..~~~. <br /> <br /> <br />OTHER <br /> <br />COMPANL- <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />