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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 BTH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-7BO-0021 <br /> <br />DATE RECE IVED <br /> <br />>? -,;21- !)t; <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />c:::..------ <br /> <br />OWNER'S NAME <;5t/1tI #2t,15;-( /1/I}--fu~ ccPrt::.f <br />JOB ADDRESS .:5-L)S~ &-19)J 13 / V D <br /> <br />PHONE 262~704-~-?O) <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # II ;}.6 ;;J./ U{)/0099oo oo/CJ <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: (]NEW CONSTRUCTION <br />(] SIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />I;i?fCOMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />(] ADDITION <br />(] MOVE <br /> <br />[2Hu.TERATION <br /> <br />(] REPAIR <br /> <br />(] INSTALL <br /> <br />(] DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />(] SWIMMING POOL <br /> <br />o MOBILE HOME <br />(] OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK Rr}~ce- 4/& Vr) l'-.fs <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 />(] ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />(] FLORIDA POWER <br /> <br />(] W .R.E .C. <br /> <br />(] PLUMBING <br />Jzr MECHANICAL <br /> <br />[J GAS <br /> <br />[J ROOFING <br /> <br />(] SPECIALTY <br /> <br />,. /1;!J ~;7_ <br /> <br />VALUATION OF MECHANCIAL INSTALLATIOlf\ 11:~~/"L <br /> <br />$;Z~ 700 <br /> <br />(] OTHER <br /> <br />""-..-..-.. .~~ ." <br /> <br />TYPE OF CONSTRUCTION: (] BLOCK <br /> <br />(] FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D 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 />COHPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *,* * * * * * * * * I I /'_ ~ <br /> <br />MECHANICAL A 0 COHPANY f+.&S~ r"c,11141ri I-J~'T Wu:.v. <br />SIGNATURE ~ .../k&'~ STATE CERT OR REGIST # (MtJG706;;J.. <br /> <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COHPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />