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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />t!:z~/~ <br /> <br />PHONE CONTACT FOR PERMITTING C I-- I' S e, ~ 6 , <br />(.; ~tl- 3!" cJ I <br /> <br />OWNER'S NAME .5 ~ f\ I 'c A S ~Q.. \N7A ~/ d- (' ( <br />JOB ADDRESS 7'1' t../ ~ r,. "'-- I \ A Iv tJ..... <br />( <br /> <br />PHONE ~~ .r - d-;) r:-- soa 0 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # ~Lf-J.5- ;:).,)- alSo --L:7C>r)c:>Cj- 000.0 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />181 SIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />~COMMERCIAL <br /> <br />D ADDITION <br />D MOVE <br /> <br />[JALTERATION <br />[J DEMOLISH <br /> <br />DREPAIR <br /> <br />D INSTALL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />[J# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOBILE HOME <br />D OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />~ I'-"'\-c,\l <br />, <br /> <br />401... <br /> <br />q" I <br />X<?' <br /> <br />.......""-11 <br /> <br />~ ,'<" <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & 12} 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 />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (l) SET ENERGY FORMS. <br />FORMS. <br />~)"" (;CJ) t;. <br /> <br />PERMITS REQUESTED <br /> <br />'3), <br /> <br />fi-lfLc. (/.::.. <br />LI '-IJ- ili() <br /> <br />lXI BUILDING <br />[J ELECTRICAL <br /> <br />$ <br /> <br />'7 3/_ 6~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J GAS <br /> <br />D ROOFING <br /> <br />D SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br /> <br />[J PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />U1 OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />SIGNATURE <br /> <br /> <br />C=ONTR1t.QTQ;R,.SBCTIQN <br />O~)'.,.e <br /> <br />COMPANY <br /> <br />5;~ i'-6 <br />- <br /> <br />~ '/'--(' . <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # ,F5",eJ pc/) ) <br /> <br />*********************************************** <br /> <br />ELECTRICIAN <br />SIGNATURE ;;<J <br />****************************************************************** <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <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 />