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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 />/Cd~-CY <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />~ P a.:f F ..J-I..u- r <br />4h.LH., ~I t<J~ <br />~/ 6l- BLOCK <br /> <br />PHO(r 18) 77'1- Jr'VtJ <br /> <br />OWNER'S NAME (3LrrJ~ <br />JOB ADDRESS .j fu 'Ill <br /> <br />SUBDIVISIONCIlPrL!J '/lOtA.. ~ <br />(OBTAIN FROM ~Kp~o;t t'o~E1 <br /> <br />PARCEL ID # <br /> <br />o SIGN <br />PROPOSED USE:,oSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />rA ADDITION <br />o MOVE <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <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 />BUILDING SIZE <br /> <br />o RESTAURANT <br />k!.r /J()rf <br /> <br />PIe- SltI'1I'g->~7::'s <br />, . , <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />u{€.-6 -I- jJ~6/~q <br /> <br />, '-'" <br /> <br />SQUARE FOOTAGE 680 F <br /> <br />. <br /> <br />.IL ~ l(f.) I AS <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT <br /> <br />/4 '-f"f <br /> <br />PERMITS REQUESTED <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br />2J()I~~ I~L:S)~' <br /> <br />QC;-'O'::':> ~. <br /> <br />5z..';~ /Lil.'\ l,. <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF EUILDING 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 />r/;J BUILDING <br />Ii ELECTRICAL <br />~ PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />(yJ <br />~J 000. <br />. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <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 />~ FRAME <br /> <br />o STEEL <br /> <br />oJ-OTHER tA-!Ulrn,iYlU"'" t'oof2 <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 />***t!~~tf***~/i\'f~******************************************* <br /> <br /> <br />COMPANY <br /> <br />otVU-r <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE . STATE CERT OR REGIST # <br /> <br />PLUMBER **~1fi***~***j*~~***********:::::::****:~*;:*;*...*........ <br /> <br /> <br />SIGNATURE ~ STATE CERT OR REGIST i <br />11 L r() r'" l: t-i..ur . <br />****y**** ~*********t******************************************** <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 />