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<br />1/ / ..,f ~ <br />~l /t 6/,,5 ,~ <br />IV ,,' , 'i "IJ <br />0~~i;\r' <br />C;/ lA <br />rP <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME [3o~.J:?rL... ~ ~O oS T PHONE <br />JOB ADDRESS '... -S- ? /J Y / ,'3 ~ ~ ~ b .::fE<:-1;t- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: oNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />!2fALT E RAT ION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />pa COMMERCIAL <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 />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />,M~ k 'IA- r S,' '" \s <:,. 1,., o/~-tr'I'l <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />?/'-IPcb;J <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />N.I~~ D j j PROPERTY SUR1Et !.EQ,UIRED FOR ALL }:!,EW CONSTRUCTION. <br />~ t1tZ...ALTd Dppf '111~ fl-l /~LtA(l.lJi... t <br /> <br />f)o{}(A.c.Vf1-L- pYlJct\ To C I c PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br />'~)~i.J) Ji-UkTVUC:rl- '- <br />J~1Ilm I Tl).JU..--N) <br />J~l~iL ~T~ ~i <br />I ~spli-~ l~t-..1'::> <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />J;il PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALL1~TION <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 <br /> <br />o NO <br /> <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 />SIGNATURE <br /> <br /> <br />COMPANY :If'A#~ <br />STATE CER~ O~ REGIST # <br /> <br />~ <br />R r::- c> g d~c/ 0 <br /> <br />PLUMBER <br /> <br />****************************************************** <br /> <br />MECHANIC <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />