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<br />CITY OF ZEPHYRHILLS PERMcrT APPLICATION <br />BUILDING DEPARTMENT 5335 BTH St, ZephyrhiJ.J.s, FL 33542 <br />BJ.3-7BO-0020 FAX:B13-7BO-0021 <br /> <br />DATE RECEIVED <br />PHONE CONTACT FOR PERMITTING B (~ <br /> <br />7-cJ(~- U4 <br />e55 Cco<ol$ <br /> <br />OWNER'S NAMESjLV~L oA~ eO....U-t..UNI1'f A~C(..jft110tJPHONE <br />JOB ADDRESS to 000 Sll..\)~fl.. OA ~ 'L:i2.-1 \J e. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # b4-.;;;>tc:>-.l.I-OC~C .-ceO-::-O - 0(">~:1.. <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: prNEW CONSTRUCTION o ADDITION DALTERATION o REPAIR o INSTALL <br /> DSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: DSGL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> tsCOMMERCIAL o INDUSTRIAL DSWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br />BUILDING SIZE ~A <br /> <br /> <br />"I- BUILDING <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. VJl <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. ~~ ~ <br />'RO'ERTT 'ORVET REQO'REO 'OR A"~ NEW OON'TROOT'O~ ~~ ~ l"iJ <br /> <br /> <br />PERMITS REQUESTED !~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION I <br />j <br />o Progress Energy 0 <br /> <br />I <...t..i/~ <br /> <br />i_. <br /> <br />$ <br /> <br />~o 1000 <br /> <br />(/& <br />,.. f,~S ~ <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />OF CONSTRUCTION: 0 BLOCK 0 <br /> <br />tV //1 <br />I <br /> <br />FRAME <br /> <br />)5{ OTHER <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o STEEL <br /> <br />o NO <br /> <br /> <br />..... <br />COMPANY ~N~'i.. -r~Cl'{~OLOG./f.S <br /> <br />OK,...,..- <br /> <br />BUILDER ~ {~ <br />SIGNATURE ~--. - STATE CERT OR REGIST # C 16C 1::>51111' <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 />****************************************************************** <br /> <br />MECHANICAL <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 />