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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 RECE IVED <br /> <br />q/~/of <br />gf3-7(f~-o~4S <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAM~~cl-t~~ T~ . <br />JOB ADDRESS ~I Lf'r P--'<- ~ ~--A..., ~'~ 373t.fo <br />LEGAL DESCRIPTION: LOT(S) (:)1-70 , BLOCK ~ SUBDIVISION <br />PARCEL ID # 31-c::<.5' -d-I- 0/30 - O~ - O(~~~ FROM PROPERTY TAX NOTICE) <br /> <br />PHONE <br /> <br />1 f' co2 -- 0 d'..lS <br />~ f-{~ <br />O/l5. 0' <br /> <br />WORK PROPSED: ~ CONSTRUCTION <br />o SIGN <br />PROPOSED USE:~FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK n ,. c .c Icle...tIC '\'::- <br /> <br />BUILDING SI ZE S-=-/ / g:>tt X SQUARE II? 1 e-!Q.{! HEIGHT /0 pQ Ut; <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 />~LDING <br /> <br />$ <br /> <br />PERMITS REQUESTED <br />. D <br />/ 53. O<D~ e <br />. <br /> <br />c3\Q~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />~CTRICAL <br />t:J--1siUMBING <br />~MECHANICAL <br /> <br />AMP SERVICE <br /> <br />~ogress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o OTHER <br /> <br />~ <br />/hlQ <br />'~') <br /> <br />$ <br /> <br /><:;")~ DD E:) 2> <br />--<~ r VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />~FING <br /> <br />o SPECIALTY <br /> <br />x <br /> <br />TYPE OF CONSTRUCTION: ~OCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE .A.READ YES err:rc) <br /> <br /> <br />SIGNATURE <br /> <br />'~~HH:~~~~'~~~~'~~'~~~~:~':'~~~ 13 ~~ <br /> <br />COMPANYC;;: q~ .,- ~Q4~ ~--fJe-c.- ,k\ <br />STATE CERT OR REGIST # E-R. ($)1459 / I)~ <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br /> <br />* ***************************************************** <br /> <br /> <br />COMPANY ~ ~~ Jp.- <br />STATE CERT OR REGIST # e~ J i.(.:J..S to O~ <br /> <br />HH......H~~~;~~~.~;:.\?~ "I ~ <br /> <br />STATE CERT OR REGIST * CAl.t: o <B49'g ~~~ <br /> <br />PLUMBER <br /> <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER -R .HHH:H HH':"'HHHHHH':::::N~@;;;t;;~ ,_-<b~ <br /> <br />SIGNATURE~~STATE CERT OR REGIST *~ t:3.;l.f:SCf5 <br />