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<br />CITY OF ZEPHYRHIl~LS PERMI'!' APPLICA~l'ION
<br />BUILDING DEPARTMENT 5335 8TA st, Zephyrhills, FL 33542
<br />813-780-0020 F'AX:813-780-0021
<br />
<br />DA'l'F. RECEIVED _____.
<br />
<br />OONER'S NAM;)) Q.u ()
<br />JOB ADDRESS (g d, \ L
<br />
<br />PHONE CONTACT FOR PERMITTING
<br />
<br />~M\~kC
<br />o
<br />I d t:Jv\ ~ tL~~ A-
<br />
<br />PHONE
<br />
<br />LEGAL DESCRIPTION: LOT(S) .
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />PARCEL 10 # W-,J.(r d 1- 0 OJ-O - 00300- 00 ().o
<br />
<br />(PBl'A1H F'ROH PROPERTY TAX NO'UCE.>_
<br />
<br />WORK PROPSED: [JNEW CONSTRUCTION
<br />[J SIGN
<br />
<br />[J ADDITION
<br />
<br />[J MOVE
<br />
<br />[JALTERATION
<br />o DEHOJ,ISn
<br />
<br />o REPAIR
<br />
<br />[J INSTlU,fJ
<br />
<br />PROPOSED USE: [JSGL FAMILY DWELLING
<br />[JCOMMERCIAL
<br />
<br />OMULTI - F'1\MII. Y
<br />o INDUSTRIAL
<br />
<br />Off OF UNITS
<br />OSWIMMlNG POOL
<br />
<br />o MOB 1 LE 1I0ME
<br />OOTIIER
<br />
<br />BUILDING SIZE
<br />
<br />
<br />1\PPROV1\l,
<br />
<br />DESCRIPTION or WORK
<br />
<br />HEIGHT
<br />
<br />R~SIDENTtAL: ATTACH (2) PLOT PLANS & (2)' SETS OF BUILDING PLANS & (1) SET ENERGY FOm1S.
<br />COMMERCIAL: ATTACH (3)- SETS OF BUILDING PL1\NS & (1) SET ENERGY FORMS.
<br />IF S!GN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
<br />
<br />o BUILDING .
<br />[J ELECTRICAL
<br />
<br />$
<br />
<br />'f)j
<br />51J(fJ.
<br />
<br />PERMITS REQUESTED
<br />
<br />VALU1\TION OF TOTAL CONSTRUCTION
<br />
<br />Si
<br />~'7'
<br />
<br />AMP SERVICE
<br />
<br />o FLORIDA POWER
<br />
<br />o W.n.E.C.
<br />
<br />[J PLUMBING
<br />o MECHANICAL .
<br />
<br />$,
<br />
<br />o GAS
<br />
<br />Cl ROOFING
<br />
<br />o SPECIALTY
<br />
<br />VALUATION OF MECHANCIAL INSTALLATION
<br />[J OTHER
<br />
<br />TYPE OF CONSTRUCTION: [J BLOCK
<br />
<br />[J FRAME
<br />
<br />o STEEL
<br />
<br />o OTHER
<br />
<br />FINISHED FLOOR ELEVA'fIONS
<br />
<br />IS PROJECT IN FLOOD ZONE MEAD YES t1 No
<br />
<br />
<br />SIGNATURE
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<br />- COMPANY~W' 0C hOlpJr -goo f;Y1jo J;.(
<br />STATE CERT OR REGIST If Ce.,.c...OS&/3tj
<br />
<br />BUILDER
<br />
<br />~****************************************************************
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<br />ELI:CTl\IClAN
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<br />
<br />STATE CERT OR REGIS! If
<br />
<br />******************************************************************
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<br />PLUMBER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<br />
<br />STATE CERT OR REGIST If
<br />
<br />MECHANICAL
<br />
<br />******************************************************************
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<br />COMPANY
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<br />SIGNATURE
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<br />SIGNATURE
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