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<br />CITY OF ZEPHYRHILLS PElUaT APPLICATION <br />BUILDING DEPARTMENT 5335 Sn St, Zephyrhi.lls" FL 33542 <br />813-780-0020 FAX:S13-7S0-0021 <br /> <br />DATE RECEIVED <br /> <br />q--/t, -Ot/ <br /> <br />PHONE CONTACT FOR PERMITTING "1.3, 7c/,? -3319 <br /> <br />OWNER'S NAME P, ~e C re'5+ f1'tobtlc Hnnc (Jrw Ie <br />JOB ADDRESS t. / ~() II/heK/~ f s I. 2 ~ ~ y A ,1/5 <br /> <br />PHONE <br /> <br />FI; 33S'V2-3273 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # 193 ,-.;2t - ~/. 02/,-) - OoOCKJ . ()J /,0 <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />OSIGN <br /> <br />(ORTATN FROM PROPF.RTY TAX N~TTr.F.\ <br /> <br />o ADDITION <br /> <br />OALTERATION <br />o DEMOLISH <br /> <br />~PAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />PROPOSED USE:OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />I <br />o MOBILE HOME <br />D OTHE~ <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />R~~CE: r5r6kert RwC"~ A,I-e ( CJtH/,Ii,) <br /> <br />BUILDING SIZE <br /> <br />.- <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />I ' <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUJ;LDING PLAAS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN P'ERMIT ONLY (2) SETS OF ENGINEERED P:Q\NS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PElUaTS REQUESTED <br /> <br />o BUILDING <br />D ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />/A'/7) <br /> <br />AMP SERVICE <br /> <br />o Pr"1"'1.'~5 €"~Y'''j'l flJ W.R.E.C. <br /> <br />D PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />DGAS <br /> <br />o ROOFING 0 SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD. ZONE AREAD YES D NO <br /> <br /> <br />BUILDER <br /> <br />COMPANy. <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />BLl:CTRJ:CIAN ~ Q /7 <br />SIGNATURE' "'/k ~ <br /> <br />COMPANY. PI'I+.f, ~ E/ee.J..nc' . <br />Et:- ~() /.R.'-$ <br />STATE CERT OR REGIST- # C"~f - "'-?,~7 <br /> <br />****************************************************************** <br /> <br />PLUHBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL COMPANY f:.+;/~ E,,;"'~ <br />SIGNATURE STATE CERT OR REGIST # eml!.- o.t;.';-'I7'- <br /> <br />'fIJ~3S1 <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />