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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH Stt Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 IO'~ )fO~ <br />DATE RECEIVED ~ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME Sk." bG\, Co... S~ ~ {.e r <br />JOB ADDRESSt{l~ CQ..\Meo. St. 2E''P~'1r~;{( s. <br /> <br />PHONE ~l1.1~2 l..'L ~ <br />FL <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />[JALTERATION <br /> <br />~REPAIR <br /> <br />[J INSTALL <br /> <br />o SIGN <br />PROPOSED USE: ~GL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[J MOVE <br /> <br />o DEMOLISH <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[] SWIMMING POOL <br /> <br />~OBILE HOME <br />[] OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK *fct." ~fi /d...t7~'" ! r< ~~~"" ~le.... .' <br />I L-( II 4 ( SQUARE FOOTAGE ( I L 8 <br /> <br />BUILDING SIZE <br /> <br />HEIGHT D"'~ sl.o1 <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 />[] BUILDING <br /> <br />$ <br /> <br />2,.(SO.- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] Progress Energy [] <br /> <br />W.R.E.C. <br /> <br />[] PLUMBING <br />[] MECHANICAL $ <br />[] GAS ~OOFING [] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />[] FRAME <br /> <br />[J STEEL <br /> <br />[] OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES [] NO <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />*******************************************************'k********** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />*******************************************************.k********** <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 ~t" s L e.., k e <br /> <br />SIGNATURE ~L-t2.e <br /> <br />COMPAN~(O~d..o..\J(. ~Of""j ~7S~S/~ c. <br />STATE CERT OR REGIST # (' cc 132 S- ggG <br />