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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 /- OtJ <br />DATE RECEIVED ,/0'-- 4:/:',,- I' <br /> <br />PHONE CONTACT FOR PERMITTING h:;..q vI.{ q 6 ( <br /> <br />Cr'/A ( &v- ::{i/\Q- <br />G-<t- (t . (J ( vo1 <br /> <br />PHONE <br /> <br />,--" ' <br /> <br />OWNER'S NAME ,,-* O-ry-: r <br />JOB ADDRESS 5"'1 t) 1 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # II -:1 b-.?I- Otll () -eC J f'ln -o")jJ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />OALTERATION <br />roIDEMOLISH <br /> <br />~EPAIR <br /> <br />o INSTALL <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />~MMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPR~~~~ <br /> <br />-Fe1ro-ff + V' eM.! f'd~ ,//Vd/~ ~ e:::I{Y lV' <br />SQUARE FOOTAGE ~.{' rJ () <br /> <br />\ <br />HEIGHT (tJ <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COI1MERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IE' SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. I <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. I .r t/ ~ II __ <br /> <br /> <br />~6~ <br />~ // j/lAr? <br />YALUATION OF TOTAL CONSTRUCTION ~ ~ J <br />..--. <br /> <br /> <br /> <br /> <br />~UILDING <br /> <br />U0 ,('J ad - (J () <br />./ <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />"' <br />3 <.f~. ~.-J <br />VALUATION OF MECHANCIAL INSTALLATION j2jlJJEJ. <br /> <br />o OTHER <br /> <br />$ <br /> <br />TYPE: OF CONSTRUCTION: 0 BLOCK <br /> <br />I1t FRAME <br /> <br />o STEEL <br /> <br />10'" OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES ty'NO <br /> <br /> <br />SIGNATURE <br /> <br />j /J ~ / COMPANY <br /> <br />j)(y~(~TATE CERT OR REGIST # CtfCo6oGC.i~ <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <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 />