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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 RECE IVED <br /> <br />/ tJ -;;2 9 - fJy' <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME 6-tt...AVJ) ffi/Y ic .-0 <br />JOB ADDRESS ':~1L\ DB l~ lll.-l l~o.... I~ u E- <br />. <br /> <br />LEGAL DESCRI PT I ON: LOT ( S) -1 \.. 0 L\ BLOCK <br /> <br />PHONE 9f"3 5dSO <br /> <br />SUBDIVISION (~l(YU')C\ h\C\1'rCLlN5 <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />DADDITION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />DALTERATION D REPAIR ~INSTALL <br />D DEMOLISH <br /> <br />PARCEL ID # <br /> <br />DSIGN <br /> <br />D MOVE <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />D# OF UNITS <br />o SWIMMING POOL <br /> <br />~OBILE HOME <br /> <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT <br />DESCRIPTION OF WORK~~~~\6bJ-} <br />BUILDING SIZE :;?l X L{ <6 <br /> <br />APPROVAL <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 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 />'')Kt. BUILDING <br />~ELECTRICAL <br />~LUMBING <br />~MECHANICAL <br />o GAS 0 ROOFING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />3 s <-It.( <br /> <br />AMP SERVICE <br /> <br />D Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br /> <br />STATE CERT OR <br /> <br />. \~ <br />~.rl+ CCOOO~ <br />REGIST # '=fV <br /> <br />SIGNATURE <br /> <br />W~4L;ljfJ <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />~} ~.5ift/.J..) <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY CUJ- <br />STATE CERT OR REGIST # 'C. > ODDOO(P I <br /> <br />ELECTRICIAN <br /> <br />PLUMBER <br /> <br />****************************************************************** <br /> <br /> <br />C;;;-;;.j COMPAN~~I'eJ ~ <br /> <br />w ~ ~ STATE CERT OR REGIST f r l-i-occoo 'X (J <br /> <br />........ H ~ij?n"'" H" ~~~;~~~... cY f' cr':' ~.;; ~~_ --Y17~ <br /> <br />L_LJ ~ ___ ~ STATE CERT OR REGIST <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />