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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED 7- d / ~ 0 f <br />PERMITTING ~ (,].-- 7-~5"J??~ <br /> <br />- PHONE CONTACT FOR <br />( ,/----) -) <br />/~rf)~4'(' ,("/'7 -'(; /J5~ . P~ONE <br />JOB ADDRESS .1 ~ /1- S- It F!1t A V E 2;:]J;.1 tLf II L Lt-S. 1 <br />/ ( <br />SUBDIVISION <br /> <br />OWNER'S NAME <br /> <br />~~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION <br />(J SIGN <br /> <br />(J ADDITION <br /> <br />(JALTERATION <br />(J DEMOLISH <br /> <br />~PAIR <br /> <br />(J INSTALL <br /> <br />(J MOVE <br /> <br />PROPOSED USE:~GL FAMILY DWELLING <br />(J COMMERCIAL <br /> <br />OMULTI-FAMILY <br />(J INDUSTRIAL <br /> <br />(J# OF UNITS <br />(J SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL I(U~ ;rori <br /> <br />DESCRIPTION OF WORK 1fE"lfoorf OV~ /1r#.st9ff( lfo4!--fioo-(j~ wfrlt l1Iev <br /> <br />BUILDING SIZE SQUARE FOOTAGE All.? I :sr m;GHT ~ <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~S. <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 />~UILDING <br />(J ELECTRICAL <br /> <br />f j rJ l/5- PERMITS REQUESTED <br /> <br />--~ <br /> <br />~i-~~~.VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 FLORIDA POWER 0 W. R. E . C . <br /> <br />~ ~~~~O>O <br />~OOFING <br /> <br />(J GAS <br /> <br />o SPECIALTY <br /> <br />(J OTHER <br /> <br />VALUATION OF MECHANCIAL INSTALLATIO~ <br />.. <br />\'\ <br /> <br /> <br />o PLUMBING <br /> <br />TYPE OF CONSTRUCTION: 'C!r BLOCK <br /> <br />'r,t FRAME <br /> <br />(J STEEL <br /> <br />(J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br />BUILDER <br /> <br />~()~c;!J:'();R'i.$ECTIQN I <br /> <br />. <br /> <br />COMPANY p~y (t/l- /Y leks A'6C).fr~o. ~_ <br /> <br />SIGNAT~HHH"'HE~~~*~~:~*~:*:~~:~*~H:::~~7 & 00 <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 REG 1ST # <br />