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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 />tf-df- Ot/ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />.. <br /> <br />OWNER'S NAME (Y!',.."v"p HUt'- r0r;,;~ PHONE <br />JOB ADDRESS::nY/~ C. (( )1.U<- LcF /9f <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />o SIGN <br /> <br />o ADDITION o ALTERAT ION o REPAIR o INSTALL <br />o MOVE 0 DEMOLISH <br />OMULTI-FAMILY 0# OF UNITS ~HOME <br />o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />PROPOSED USE: 0 SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />BUILDING SIZE ~ 0 <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />.M.I! sj~ <br /> <br />.r- C/'" SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <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 Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o 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 AREAO YES 0 NO <br /> <br /> <br />BUILDER COMPANY <br />SIGNATURE GcJ~"'"'~~ STATE CERT OR REGIST I <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY ft c:... e...... <br /> <br />SIGNATURE <br /> <br />LJ. c..r--P-...-M .~ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />We>, <br /> <br />.4J <br /> <br />COMPANY lt~) <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />Ld~~ <br /> <br />COMPANY <br /> <br />J<lc:::...-.~ <br /> <br />MECHANICAL <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />