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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 />/O/;5/0f/ <br /> <br />, / <br /> <br />OWNER'S NAME <br /> <br />PHONE CONTACT FOR PERMITTINGq' 0 7 CJl{~-B ..;29'3 <br />, ~ t;> <br />/l / d r: /.L ' , I 1-1 (dk'LJr I' <br />G/1 m b~y(tU( rr:trf'J1~ 1(0 rvb1e'4 PH6NE If <br />) / <br />,5Of~, GfJ/1. G/tlM / <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: 0 SGL FAMILY DWELLING <br />o COMMERCIAL <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK R-emtJt/t' t^-Itdv!-y YYf1I.vnd .'5.f~f'Pfe fan 1<- <br />BUILDING SIZE SQUARE FOOTAGE 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 />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET <br />FORMS. <br /> <br />~4 <br /> <br />ENERGY FORMS. <br /> <br />/ lLJC;, <br /> <br />'" <br />c~ <br /> <br />o BUILDING <br /> <br />PERMITS REQUESTED <br />$ ;;zf;t ~ 'br ttv VAL~ATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 Progress Energy 0 <br /> <br />o ELECTRICAL <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br /> <br />W.R.E.C. <br />"-~ <br />...-.,;J---- <br />?/ <br />/' <br /> <br />/; 3064 ' <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATIO <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />~/ <br />BUILDER ,.,,/ . <br />SIGN ./ _ _~ STATE eERT OR REGIST i Pt!-~3f <br />~ ******************************************************~*:t? tJ~~~~~? <br />~ ~! <br />ELECTRICIAN COMPANY CYr~~~ <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 />