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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 />DATE RECEIVED <br /> <br />N~ J~~t/) <br /> <br />f <br /> <br />PHONE CONTACT FOR PERMITTING goo - j :};) - 62- 51:> <br />j(e;./"'" .FelL C"'U 5 ~ ~ <br /> <br />OWNER'S NAME /-. ON (') ];) jjL) ~ / v ~ r2-S /fJ. W PHONE <br />JOB ADDRESS/"....?iLJj 04/1 ,'6/t/d 2:- E,) J. vC; /2- At / /5 <br />/' <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[JADDITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[J SIGN <br /> <br />[J MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />OMULTI - FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />CJ RESTAURANT <br />~ f!- [/ /J 1Jtu5t1 ( <br />I <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />5'~,~;171 ' <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 FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />[J BUILDING <br /> <br />$ A300 ,00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />IfJ <br />v L1 ~. <br /> <br />PERMITS REQUESTED <br /> <br />[J ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J Progress Energy [J <br /> <br />W.R.E.C. <br /> <br />[J PLUMBING <br />~ECHANICAL <br /> <br />$J-5>DCJJoD <br /> <br />[J GAS <br /> <br />[J ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <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 />OTHER <br /> <br /> <br />***************************************************************** <br /> <br /> <br />U COMPANY Ii 1C1llft1lJ})D ;:110 >,-SItF-t..!; <br />STATE CERT OR REGIST # {j-:J}!, -?? S~/ )1i> IS <br /> <br />SIGNATURE <br />