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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 RECEIVED <br /> <br />'f!< ?-/? y <br /> <br />.... , <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME (-11,....,,1/\..) I-!OR/1.,,,,v <br /> <br />PHONE <br /> <br />- <br />JOB ADDRESS t." I / 9 / <br /> <br />.?7Y.N C~I~ll /'9ff-<L <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: ONEW CONSTRUCTION <br />OS IGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />(ORTAIN FROM PROPRRTY TAX NOTIr.El <br /> <br />o ADDITION <br /> <br />DALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />[] INS TALL <br /> <br />o MOVE <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~ILE HOME <br />[] OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK m, H <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 />o ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />[] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br />BUILDER <br /> <br />g~~~mi~,t~~~~,~~2l.;i <br />COMPANY 1?.:J.L-flJ <br />/7~~ STATE CERT OR REGIST # <br /> <br />SIGNATURE { ..u. ~ <br /> <br />*********************************~******************************** <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />w~~~p <br /> <br />COMPANY .11~ ',- <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />w~ <br /> <br />L1:JL~P <br /> <br />COMPANY 11~J#J <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br />COMPANY l'ge ~ <br /> <br />0J ~-/3.2L/h; <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />