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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUILDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542
<br />813-780-0020 FAX: 813-780-0021
<br />
<br />PHONE CONTACT FOR
<br />
<br />DATE RECEIVED ! &-2/-0(
<br />1;/3-'633-07'0
<br />PEBMITTING
<br />Le~' I e..
<br />
<br />OWNER'S NAME ? e c k.. .en ~Ch (j-Q I cl ~ r' & e+
<br />JOB ADDRESS ',,-5'd-SI .F)~ ~T
<br />'C- ' k'f) J of
<br />LEGAL DESCRI PTION: LOT ("'!t( /. ,;;< . ~ 3 BLOCK! 3 I
<br />" I
<br />
<br />PARCEL 10 # !/ - ;(b- ;)/-00 I () -/~/CO - 001 ()
<br />
<br />PHONE
<br />
<br />r: \t'-l o-f -2epA .
<br />SUBDIVISIO~ I .
<br />
<br />(OBTAIN FROM PROPERTY TAX NOTICE)
<br />
<br />WORK PROPSED: 0 NEW CONSTRUCTION
<br />
<br />o ADDITION
<br />
<br />o ALTERATION
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />DSIGN
<br />PROPOSED USE: DSGL FAMILY DWELLING
<br />o 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 He
<br />o OTHER
<br />
<br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL
<br />DESCRIPTION OF WORK ('./0(1( re~ IJ(", v"f' u n V'
<br />/
<br />
<br />BUILDING SIZE
<br />
<br />SQUARE FOOTAGE
<br />
<br />HEIGHT
<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~ORMS.
<br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. :tJ>LJ..r c::. .?_i Vb
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. I~, T~
<br />
<br />
<br />4f~~3?-
<br />
<br />PERMITS REQUESTED
<br />
<br />~UILDING
<br />
<br />$
<br />
<br />3000
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />o ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />o Progress Energy 0
<br />
<br />W.R.E.C.
<br />
<br />o PLUMBING
<br />o MECHANICAL
<br />
<br />$
<br />
<br />VALUATION OF MECHANCIAL INSTALLATION
<br />
<br />o GAS
<br />
<br />o ROOFING
<br />
<br />o SPECIALTY
<br />
<br />o OTHER
<br />
<br />TYPE OF CONSTRUCTION: 0 BLOCK
<br />
<br />o FRAME
<br />
<br />o STEEL
<br />
<br />o OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO
<br />
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<br />
<br />BUILDER3 e ~ S .~C)\ + COMPANY -:s- SB CCJV\-\-~ '8 eVYl
<br />SIGNATU~..a//?L ~~ STATE CERT OR REGIST * 0Jc 15D'I;;jtJj
<br />
<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 />
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