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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE lVED <br /> <br />/0-:2 7-0 r <br /> <br />PHONE CONTACT FOR PERMITTING IZ3 - 7cf...<' -..33 J <; <br /> <br />OWNER'S NAME 7ti.hJ l..J r.S eem Q.../J <br />JOB ADDRE ss ..3lJ / " fJ 'f rli-~ f) r / pt <br />LEGAL DESCRIPTION: LOT (S) /9'1 BLOCK <br />PARCEL ID # tJ.l/- ~ft, - cJ. /- (}()J"O - tJOOW- J 99 () <br /> <br />Q.A'=-C....... PCDi.l.JlI-r ~>CO\#'Piit::: <br />P~(JRW \.1 (:;;:Irlnnt .....1["";r;&I:'lVIIil, <br />1-005-824-7894 <br />Tol! Froo <br /> <br />SUBDIVISION C~I"L~ /JOIAle <br />Kl/ Uorr <br />(OBTAIN FROM PROPERTY TAX NOTTr.E\ <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[J ADDITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[J SIGN <br /> <br />o MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE: OSGL 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 />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />E 1 e.c::.Tr- i L- fO y- R v' Po r t- <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 />& (1) SET ENERGY FORMS. <br />FO;. <br />"':~S.,~N <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br />t,& ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o fr~'lvC"~s En "C'Y';Ff <br /> <br />\ <br />j , J <br />/JJO .' <br />(11 ~7 ,/ <br />:' r~ <br />v~ ~ // <br />INSTALLATION "'--_,-.......-..../' <br /> <br />o <br /> <br />W.R.E.C... <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL <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 AREAO YES 0 NO <br /> <br />CONTRACTOR.SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRIC~ <br />SIGNATURE '4-,.. aJ~ <br /> <br />COMPANY PI9+ft ~ Ele-efn'c <br />ec - C'JO 0 1.f{~8' <br />STATE CERT OR REGISTH # C.-It - ""'.,;,l.'3'1 <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />*************************************************~*******~*****~ <br />~;; -. 1ft\: <br />COMPANY ,,-, .".... """"rr<..-, ~c IVJ <br />. <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST #- ~e- .5 5~ i~t <br /> <br /># ..139- <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />