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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 f(Iz~/(JtY <br /> <br />PHONE CONTACT FOR PERMITTING YI3 ''''-I69-S5S't.j <br />352-~'-7(,~3 <br /> <br />OWNER'S NAME D rA f f Mdt! {OnJ{} <br />JOB ADDRESS 3&-' ~?'1 Cv-/lpt1~ <br /> <br />Ots<; tJ e. <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL ID # 02 U 2-1 02-1 <br /> <br />BLOCK <br /> <br />SUBDIVISION <br />o 0 ,. QOB'J'AIN FROM <br />-'------ ---- PROPF.R'J'Y TAX NOTIr.F.l <br /> <br />B ()() HOu <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[J ADDITION <br />[J MOVE <br /> <br />(JALTERATION <br />[J DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT <br />f<.~ - % ~ <br />I <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />BUILDING SIZE <br /> <br /><go :7~ <br />V <br /> <br />)' lv.' ~ /.., ./< <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 />[J BUILDING <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />/0 ~- .- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />$ <br /> <br />[JGAS <br /> <br />[J ROOFING <br /> <br />[J SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />GQ~Q!J:.'QRJ$ECTION <br />,.....'.:......,... .'.,....,.. " . < <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 />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER ,1 (J (7~f ..v! <br />SIGNATURE ~~~~. <br /> <br />***************************************************************** <br /> <br />COMPANY <;( tll/ !S I#{u.&~) ~..y,-:J <br />STATE CERT OR REGIST # (>,CCL) ~7 q~~1 <br />