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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 RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME U~l?r c7(7),f"'!.IIN <br />JOB ADDRESS .~~2"Z 23d 5"~ <br /> <br />PHONE JJ/3 - nO -- z y2 'I <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # 11-26-2/-f)oI./D.... oOS"OO- ot:>'2.c <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />0'ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />PROPOSED USE: ~GL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />F/rc.6/!l t4-~ <br /> <br />f€72 v/er:.- e;I~-q;l2l9di="' <br />, , <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (I) SET ENERGY FORMS. <br />FORMS. <br /> <br />o BUILDING <br />~ELECTRICAL <br /> <br />$ <br /> <br />12~o ~ <br />2ot> <br /> <br />/// <br />/ <br /> <br />PERMITS REQUESTED I <br /> <br />VALUATION OF TOTAL CONSTRUC~ <br /> <br /> <br />;/ :? 5'1 <br /> <br />AMP SERVICE <br /> <br />~ Progress Energy [] <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />o FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />~**********************************:::::::~~~:::;**;;;~~:**** <br />. /2 ..,L STATE CERT OR REGIST # t14 2?S-S-- <br />F <br /> <br />ELECTRICIAN <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 />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />