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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 eTH St, Zephyrhills, Fl. 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />Qfr,((JY <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />c-,... W'J!J <br />3/lj2'( <br /> <br />;fo~ 12:,u <br />Cr, 'f / J4 (J -'<- <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />L(rJ 193 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: ONEW CONSTRUCTION <br />OS IGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERC IAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o ADDITION o ALTERAT ION o REPAIR o INSTALL <br />o MOVE 0 DEMOLISH <br />OMULTI-FAMILY 0# OF UNITS eMOBILE HOME <br />o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />/n c jr/ <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 />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />b MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <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 />BUILDER <br /> <br />~ ...... <br />~';I!(j!it'~:liECT:t~ . <br />. .. ".C:P~~' ~~."dj!) <br />~ .n <br />r.."J ~ STATE CERT OR REGIST # ' <br /> <br /> <br />* **** * * * * ** * * **** -1(** * **** * ** * * * * ** * **** **** *** ** * ** * * **,* ** ** * ** * * <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />iJ~~ ;;fJ(i2 <br /> <br />COMPANY <br /> <br />J7/c~ <br />, <br /> <br />ELECTRICIAN <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY tJ .~J:j <br />STATE CERT OR REGIST # <br /> <br />V';;1 <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />J9 c '-' <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />